Comparison of Clinical Outcomes among Different Fixed-dose Combinations of Long-acting Muscarinic Antagonists and Long-acting β < sub > 2 < /sub > -agonists (LAMA/LABA) in Patients with Chronic Obstructive Pulmonary Disease

Chest. 2022 Nov 26:S0012-3692(22)04197-6. doi: 10.1016/j.chest.2022.11.027. Online ahead of print.ABSTRACTBACKGROUND: Researchers have yet to obtain conclusive evidence differentiating among fixed-dose combinations (FDCs) of long-acting muscarinic antagonists (LAMAs) and long-acting beta-agonists (LABAs) for chronic obstructive pulmonary disease (COPD) in terms of real-world clinical outcomes.RESEARCH QUESTION: What are the differences between available LAMA/LABA FDCs on the risk of acute exacerbation and cardiovascular events?STUDY DESIGN AND METHODS: This retrospective cohort study based on a national insurance claims database included COPD patients aged 40 and older who were newly prescribed glycopyrronium/indacaterol (GLY/IND), umeclidinium/vilanterol (UMEC/VI), or tiotropium/olodaterol (TIO/OLO) FDC between January 1, 2015, and June 30, 2019. Propensity score matching and Cox regression models were used to compare outcomes of acute exacerbation (AE) and cardiovascular events associated with LAMA/LABA FDC treatment.RESULTS: Among the 44,498 patients identified and included, 15,586 received GLY/IND, 20,460 received UMEC/VI, and 8,452 received TIO/OLO. Baseline characteristics were well balanced after 1:1 matching of UMEC/VI and GLY/IND, 2:1 matching of UMEC/VI and TIO/OLO, and 2:1 matching of GLY/IND and TIO/OLO. Risk of severe AE was lower among patients treated with UMEC/VI or GLY/IND than among those who received TIO/OLO (UMEC/VI vs. TIO/OLO: 17.85 vs. 29.32 per 100 per...
Source: Chest - Category: Respiratory Medicine Authors: Source Type: research