Respiratory investigation · 2025
Exacerbation and cardiopulmonary risk after prompt initiation of single-inhaler budesonide /glycopyrrolate/formoterol fumarate following COPD exacerbations: Insights from MITOS EROS (Japan) study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Takahashi Koichiro, Yoshida Yuri, Makita Naoyuki, Nishida Kenichiro, Yoshimura Michihiro, Cheng Zhao, Salosensaari Aaro, Camarinha Catarina, Yamaura Reiko, Cuntin Marta, Pollack Michael
Аннотация
BACKGROUND: Previous evidence supported prompt initiation of single-inhaler triple therapy in chronic obstructive pulmonary disease (COPD), but data specific to Japan are lacking. This study investigated the association between budesonide/glycopyrrolate/formoterol fumarate (BGF) initiation and subsequent COPD exacerbations or severe cardiopulmonary events in Japanese patients initiating BGF following previous exacerbations.
METHODS: This was an observational cohort study among patients with COPD using IQVIA Integrated claims data. Between BGF launch (September 2019) and March 2023, patients aged ≥40 years initiating BGF following COPD exacerbations (index) were included. Patients were categorized into BGF initiation groups by treatment initiation timing following index exacerbations: prompt (≤30 days), delayed (31-180 days), and very delayed (181-365 days). Multivariable negative binomial regression models evaluated the associations between BGF initiation strategies and subsequent exacerbations or severe cardiopulmonary events.
RESULTS: 3402 eligible patients were included: 840 prompt, 1143 delayed, and 1419 very delayed BGF initiators. The crude COPD exacerbation event rate (95 % confidence interval [CI]) per person-year was 1.66 (1.58-1.74) for prompt, 2.36 (2.30-2.43) for delayed, and 2.60 (2.54-2.66) for very delayed initiators during follow-up. Compared to prompt initiation, delayed (adjusted rate ratio [RR]: 1.25; 95 % CI: 1.13-1.38) and very delayed (adjusted RR: 1.09; 95 % CI: 0.99-1.20) BGF initiation showed an increased risk of COPD exacerbations. No associations were observed between BGF initiation strategies and severe cardiopulmonary events.
CONCLUSION: Following COPD exacerbations, initiating BGF promptly was associated with reduction in subsequent exacerbations. Patients should receive prompt and proactive treatment to reduce COPD morbidity.
METHODS: This was an observational cohort study among patients with COPD using IQVIA Integrated claims data. Between BGF launch (September 2019) and March 2023, patients aged ≥40 years initiating BGF following COPD exacerbations (index) were included. Patients were categorized into BGF initiation groups by treatment initiation timing following index exacerbations: prompt (≤30 days), delayed (31-180 days), and very delayed (181-365 days). Multivariable negative binomial regression models evaluated the associations between BGF initiation strategies and subsequent exacerbations or severe cardiopulmonary events.
RESULTS: 3402 eligible patients were included: 840 prompt, 1143 delayed, and 1419 very delayed BGF initiators. The crude COPD exacerbation event rate (95 % confidence interval [CI]) per person-year was 1.66 (1.58-1.74) for prompt, 2.36 (2.30-2.43) for delayed, and 2.60 (2.54-2.66) for very delayed initiators during follow-up. Compared to prompt initiation, delayed (adjusted rate ratio [RR]: 1.25; 95 % CI: 1.13-1.38) and very delayed (adjusted RR: 1.09; 95 % CI: 0.99-1.20) BGF initiation showed an increased risk of COPD exacerbations. No associations were observed between BGF initiation strategies and severe cardiopulmonary events.
CONCLUSION: Following COPD exacerbations, initiating BGF promptly was associated with reduction in subsequent exacerbations. Patients should receive prompt and proactive treatment to reduce COPD morbidity.