Patient and Clinical Demographics of New Users to Single-Inhaler Triple Therapy in Patients with Chronic Obstructive Pulmonary Disease

Benjamin Wu; David Mannino; George Mu; Marjorie Stiegler; Michael Bogart

doi:10.1007/s41030-022-00189-6

Patient and Clinical Demographics of New Users to Single-Inhaler Triple Therapy in Patients with Chronic Obstructive Pulmonary Disease

Pulm Ther. 2022 Jun;8(2):195-208. doi: 10.1007/s41030-022-00189-6. Epub 2022 Apr 25.

Authors

Benjamin Wu¹, David Mannino¹, George Mu², Marjorie Stiegler^{1

3}, Michael Bogart⁴

Affiliations

¹ GlaxoSmithKline, 5 Moore Drive, Research Triangle Park, PO Box 13398, Durham, NC, 27709-3398, USA.
² GlaxoSmithKline, UP Campus, 1250 S Collegeville Road, Collegeville, PA, 19426, USA.
³ University of North Carolina Chapel Hill, N2198 UNC Hospitals CB# 7010, Chapel Hill, NC, 27599-7010, USA.
⁴ GlaxoSmithKline, 5 Moore Drive, Research Triangle Park, PO Box 13398, Durham, NC, 27709-3398, USA. michael.r.bogart@gsk.com.

Abstract

Introduction: Single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) triple therapy was approved by the United States Food and Drug Administration in 2017 as a maintenance therapy for chronic obstructive pulmonary disease (COPD). Patient characteristics and treatment patterns prior to initiating FF/UMEC/VI are currently unknown. This study assessed patient characteristics, exacerbation, and medication history in patients with COPD before the initiation of FF/UMEC/VI or multiple-inhaler triple therapy (MITT).

Methods: This was a retrospective study using the Optum Clinformatics^® Data Mart. Patients who initiated FF/UMEC/VI triple therapy or MITT (consisting of a long-acting muscarinic antagonist [LAMA], long-acting β2-agonist [LABA], and inhaled corticosteroid [ICS]) between October 2017 and September 2018, were enrolled in commercial or Medicare Advantage Prescription Drug plans, were aged > 40 years, and had a COPD diagnosis were eligible. Patient characteristics, comorbidities, COPD medication use, exacerbations, and eosinophil counts were assessed in the 12-month baseline period prior to initiation of FF/UMEC/VI triple therapy or MITT.

Results: The study population included 3933 FF/UMEC/VI users and 18,244 MITT users. Mean (standard deviation) patient age was 72.2 (8.6) years in FF/UMEC/VI users and 70.7 (9.7) years in MITT users. Prior to initiating triple therapy, the majority of FF/UMEC/VI (89.1%) and MITT (93.8%) users experienced a moderate or severe exacerbation or used a COPD maintenance therapy during the baseline period. In addition, 41.2% of FF/UMEC/VI users received overlapping ICS/LAMA/LABA, 20.3% received ICS/LABA, and 9.7% received LAMA/LABA.

Conclusion: In this population of COPD patients, triple therapy was frequently initiated after previous maintenance medication use or an exacerbation, in line with treatment guideline recommendations.

Keywords: Chronic obstructive pulmonary disease; Exacerbation; Real-world data; Single-inhaler triple therapy; Treatment patterns; Triple therapy.