Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 12

A retrospective study to assess clinical characteristics and time to initiation of open-triple therapy among patients with chronic obstructive pulmonary disease, newly established on long-acting mono- or combination therapy

Authors Mapel D, Laliberté F, Roberts MH, Sama SR, Sundaresan D, Pilon D, Lefebvre P, Duh MS, Patel J

Received 29 November 2016

Accepted for publication 27 March 2017

Published 21 June 2017 Volume 2017:12 Pages 1825—1836

DOI https://doi.org/10.2147/COPD.S129007

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Richard Russell

Douglas Mapel,1 François Laliberté,2 Melissa H Roberts,1,3 Susan R Sama,4 Devi Sundaresan,4 Dominic Pilon,2 Patrick Lefebvre,2 Mei Sheng Duh,5 Jeetvan Patel6

1Health Services Research Division, Lovelace Clinic Foundation, Albuquerque, NM, USA; 2Groupe d’analyse, Montreal, QC, Canada; 3Department of Pharmacy Practice and Administrative Sciences, University of New Mexico, College of Pharmacy, University of New Mexico, Albuquerque, NM, 4Research Department, Reliant Medical Group, Worcester, MA, 5Analysis Group, Boston, MA, 6US Health Outcomes, GlaxoSmithKline, Research Triangle Park, NC, USA

Introduction: An incremental approach using open-triple therapy may improve outcomes in patients with chronic obstructive pulmonary disease (COPD). However, there is little sufficient, real-world evidence available identifying time to open-triple initiation.
Methods: This retrospective study of patients with COPD, newly initiated on long-acting muscarinic antagonist (LAMA) monotherapy or inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combination therapy, assessed baseline demographics, clinical characteristics, and exacerbations during 12 months prior to first LAMA or ICS/LABA use. Time to initiation of open-triple therapy was assessed for 12 months post-index date. Post hoc analyses were performed to assess the subsets of patients with pulmonary-function test (PFT) information and patients with and without comorbid asthma.
Results: Demographics and clinical characteristics were similar between cohorts in the prespecified and post hoc analyses. In total, 283 (19.3%) and 160 (10.9%) patients had moderate and severe exacerbations at baseline, respectively, in the LAMA cohort, compared with 482 (21.3%) and 289 (12.8%) patients in the ICS/LABA cohort. Significantly more patients initiated open-triple therapy in the LAMA cohort compared with the ICS/LABA cohort (226 [15.4%] versus 174 [7.7%]; P<0.001); results were similar in the post hoc analyses. Mean (standard deviation) time to open-triple therapy was 79.8 (89.0) days in the LAMA cohort and 122.9 (105.4) days in the ICS/LABA cohort (P<0.001). This trend was also observed in the post hoc analyses, though the difference between cohorts was nonsignificant in the subset of patients with PFT information.
Discussion: In this population, patients with COPD are more likely to initiate open-triple therapy following LAMA therapy, compared with ICS/LABA therapy. Further research is required to identify factors associated with the need for treatment augmentation among patients with COPD.

Keywords:
COPD, open-triple therapy, long-acting muscarinic antagonists, inhaled corticosteroids, long-acting β-agonists

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]