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Effectiveness of Treatment With Dual Bronchodilation (LABA/LAMA) Compared With Combination Therapy (LABA/ICS) for Patients With COPD: A Population-Based Study
Monteagudo, Mònica; Nuñez, Alexa; Barrecheguren, Miriam; Miravitlles, Marc.
Afiliação
  • Monteagudo, Mònica; Primary Care University Research Institute Jordi Gol (IDIAP Jordi Gol). Universitat Autònoma de Barcelona (UAB). Medicine Department. Barcelona. Spain
  • Nuñez, Alexa; Hospital Universitari Vall d’Hebron. Pneumology Department. Vall d’Hebron Barcelona Hospital Campus. Barcelona. Spain
  • Barrecheguren, Miriam; Hospital Universitari Vall d’Hebron. Pneumology Department. Vall d’Hebron Barcelona Hospital Campus. Barcelona. Spain
  • Miravitlles, Marc; Hospital Universitari Vall d’Hebron. Pneumology Department. Vall d’Hebron Barcelona Hospital Campus. Barcelona. Spain
Arch. bronconeumol. (Ed. impr.) ; 58(10): 699-707, Oct. 2022. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-210062
Biblioteca responsável: ES1.1
Localização: ES15.1 - BNCS
ABSTRACT

Background:

Initiation of treatment of COPD with a combination of a long-acting beta-agonist (LABA) and an inhaled corticosteroid (ICS) is frequent irrespective of the risk of exacerbations.

Method:

We performed a retrospective, population-based, observational study aimed at comparing the effectiveness of a LABA/long-acting antimuscarinic agent (LAMA) and LABA/ICS in patients with COPD over a one-year follow-up. Data were obtained from an administrative healthcare claims database. The primary outcome was the risk of first exacerbation. A sensitivity analysis was conducted in a propensity-score matched population.

Results:

The population consisted of 14,046 COPD patients; 11,329 (80.6%) initiated LABA/ICS and 2717 (19.4%) LABA/LAMA. The matched population included 1650 patients in each arm. During follow-up, 69.6% patients in the LABA/ICS group and 64.4% in the LABA/LAMA group presented an exacerbation. The mean time to the first exacerbation was 6.03 months (95% confidence interval (CI) 5.94–6.12) for LABA/ICS and 6.4 months (95%CI 6.21–6.59) for LABA/LAMA; p<0.001. The time to scalation to triple therapy was also significantly prolonged in LABA/LAMA. Similar results were obtained in the matched population. LABA/LAMA was associated with a significantly lower risk of exacerbations and escalation to triple therapy compared to LABA/ICS, except in patients with frequent exacerbations and high blood eosinophils in which no differences were observed in the time to first exacerbation.

Conclusion:

Initiation of treatment with LABA/LAMA was associated with a lower risk of exacerbation and escalation to triple therapy compared to LABA/ICS in the majority of patients with COPD in primary care. (AU)
Assuntos


Texto completo: Disponível Coleções: Bases de dados nacionais / Espanha Base de dados: IBECS Assunto principal: Broncodilatadores / Doença Pulmonar Obstrutiva Crônica Limite: Adulto / Idoso / Feminino / Humanos / Masculino Idioma: Inglês Revista: Arch. bronconeumol. (Ed. impr.) Ano de publicação: 2022 Tipo de documento: Artigo Instituição/País de afiliação: Hospital Universitari Vall d’Hebron/Spain / Primary Care University Research Institute Jordi Gol (IDIAP Jordi Gol)/Spain

Texto completo: Disponível Coleções: Bases de dados nacionais / Espanha Base de dados: IBECS Assunto principal: Broncodilatadores / Doença Pulmonar Obstrutiva Crônica Limite: Adulto / Idoso / Feminino / Humanos / Masculino Idioma: Inglês Revista: Arch. bronconeumol. (Ed. impr.) Ano de publicação: 2022 Tipo de documento: Artigo Instituição/País de afiliação: Hospital Universitari Vall d’Hebron/Spain / Primary Care University Research Institute Jordi Gol (IDIAP Jordi Gol)/Spain
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