A Retrospective Claims Analysis of Dual Bronchodilator Fixed-Dose Combination Versus Bronchodilator Monotherapy in Patients with Chronic Obstructive Pulmonary Disease.

Patients with chronic obstructive pulmonary disease (COPD) increasingly receive combination bronchodilator therapies. Real world evidence for the benefits of combination therapy compared to monotherapy is lacking. COPD patients aged ≥ 40 years initiating monotherapy (MT) with either a long-acting muscarinic antagonist (LAMA) or long-acting beta2-agonist (LABA) or dual therapy (DT) with a LAMA/LABA fixed dose combination (FDC) between January 1, 2016 and December 31, 2016 were identified from a large U.S. administrative claims database. Patients diagnosed with cystic fibrosis, idiopathic pulmonary fibrosis, or asthma were excluded. Cohorts were propensity score matched 1:1 using baseline measures (e.g., exacerbations, hospitalizations) as proxies for COPD severity to create balanced cohorts. Following propensity score matching (PSM), 1286 patients remained in each cohort for analysis. Patients were followed for approximately 1 year. Patients in the DT versus MT cohort had lower rates of exacerbations leading to hospitalization (incidence rate ratio 0.7886; Patients in the DT cohort had lower rates of exacerbations leading to hospitalization, lower COPD-related pharmacy and total costs PPPM, and lower rates of switching and augmentation compared to patients in the MT cohort.

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JCOPDF © 2019.

Déclaration de conflit d'intérêts

This study was funded by AstraZeneca Pharmaceuticals LP (Wilmington, Delaware). Optum, Inc., was contracted by AstraZeneca Pharmaceuticals LP to conduct this study and develop the manuscript. Dr. Charlie Strange reports personal fees and non-financial support from AstraZeneca, CSA Medical, GlaxoSmithKline, and BTG, grants, personal fees, non-financial support from Pulmonx, personal fees from Uptake Medical, and grants from MatRx, all in COPD outside the submitted work. Mr. Jonathan Kurlander, Ms. Maureen Carlyle, Dr. Junliang Tong, and Ms. Valery Walker received support from AstraZeneca during the time that this study was conducted. Dr. Eric Wittbrodt reports that he is an employee of AstraZeneca. Dr. Lauren A. Millette reports that she was an employee of AstraZeneca during the time that this study was conducted and is currently an employee of Genentech. The authors report no other conflicts of interest in this work.