Budesonide/Glycopyrrolate/Formoterol for the Management of COPD in a UK Primary Care Population: Real-World Use and Early Medication Success.
Int J Chron Obstruct Pulmon Dis
; 19: 1153-1166, 2024.
Article
en En
| MEDLINE
| ID: mdl-38813078
ABSTRACT
Purpose:
Real-life research is needed to evaluate the effectiveness of budesonide/glycopyrrolate/formoterol (BGF) in routine COPD primary care management. We assessed the frequency of medication success among patients with COPD who initiated BGF using real-world data. Patients andMethods:
Patients with a recorded diagnostic COPD code who started BGF with ≥2 prescriptions within 90-days were identified in the UK Optimum Patient Care Research Database and followed from first prescription until censoring at the end of follow-up (180-days), death, leaving database or end of data at 24/10/2022. The primary outcome was medication success at 90-days post-BGF initiation, defined as no major cardiac or respiratory event (ie no complicated COPD exacerbation, hospitalization for any respiratory event, myocardial infarction, new/hospitalized heart failure, and death) and no incidence of pneumonia. Medication success was also assessed at 180-days post-BGF initiation. Overall real-life medication success was claimed if the lower 95% confidence interval (CI) for the proportion of patients meeting the primary outcome was ≥70% (defined a priori).Results:
Two hundred eighty-five patients were included. Prior to BGF initiation, these patients often had severe airflow obstruction (mean ppFEV1 54.5%), were highly symptomatic (mMRC ≥2 77.9% (n = 205/263); mean CAT score 21.7 (SD 7.8)), with evidence of short-acting ß2-agonist (SABA) over-use (≥3 inhalers/year 62.1%, n=179/285), repeat OCS prescriptions (≥2 courses/year 33.0%, n = 95/285) and multiple primary care consultations (≥2 visits/year 61.1%, n = 174/285). Overall, 39.6% of patients (n = 113/285) switched from previous triple therapies. Real-life medication success was achieved by 96.5% of patients (n = 275/285 [95% CI 93.6, 98.3]) during 90-days treatment with BGF and by 91.8% (n = 169/184 [95% CI 86.9, 95.4]) of patients at 180-days. The prescribed daily dose of SABA remained stable over the study period.Conclusion:
The majority of patients initiating BGF experienced real-life medication success reflecting the absence of severe cardiopulmonary events. These benefits were apparent after 90-days of treatment and sustained over 180-days.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Atención Primaria de Salud
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Broncodilatadores
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Bases de Datos Factuales
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Enfermedad Pulmonar Obstructiva Crónica
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Agonistas de Receptores Adrenérgicos beta 2
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Glicopirrolato
Límite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Int J Chron Obstruct Pulmon Dis
Año:
2024
Tipo del documento:
Article
País de afiliación:
Reino Unido