Single-inhaler triple treatment for COPD lowers exacerbation and mortality in COPD patients

In a new study conducted by Bernardino Alcázar-Navarrete and colleagues, it was found that COPD patients who started Single-inhaler triple therapy (SITT) showed a clinically meaningful improvement in persistence, which decreased mortality, the occurrence of exacerbations, and the utilization of healthcare resources, all of which resulted in a mean cost savings. The findings of this study were published in the Chest Journal.

Chronic obstructive pulmonary disease (COPD) is a leading contributor to mortality and disability. Reducing exacerbations and enhancing symptom management are two objectives of COPD treatment. Patients who experience frequent exacerbations despite receiving bronchodilator medication should get either single-inhaler triple therapy (SITT) or multiple-inhaler triple therapy (MITT). In terms of treatment persistence, exacerbations, and other outcomes, there is presently no information contrasting SITT to MITT in Spain. This study was carried out in order to determine if COPD patients in Spain commencing SITT or MITT have improved persistence, exacerbations, and healthcare resource consumption.

This observational, retrospective, real-world cohort analysis identified COPD patients aged 40 years beginning SITT or MITT (using two or three inhalers) between June 1, 2018, and December 31, 2019, by examining electronic health records in the Spanish National Healthcare System BIG-PAC® database. During a 12-month follow-up, comparative data on persistence (allowing up to 60 days without a medication refill), exacerbation rates, healthcare resource consumption, and expenditures were examined. Analyses with many variables were conducted.

The key findings of this study were as follow:

1. The mean age of the eligible patients (n=4625) commencing SITT (n=1011) or MITT (n=3614) was 70.9 years; the majority (73.9%) were men; and the majority of them had moderate (62.0%) or severe (26.5%) airflow limitations.

2. Baseline traits between cohorts were comparable.

3. In comparison to MITT patients, SITT patients exhibited higher persistence, a lower risk of exacerbations, and a decreased risk of all-cause death at the 12-month follow-up.

4. SITT was linked to a greatly reduced utilization of healthcare resources.

5. Persistence was linked to lower exacerbation rates compared to non-persistence for SITT and MITT, as well as significant adjusted MACS.

Reference:

Alcázar-Navarrete, B., Jamart, L., Sánchez-Covisa, J., Juárez, M., Graefenhain, R., & Sicras-Mainar, A. (2022). Clinical characteristics, treatment persistence and outcomes among patients with COPD treated with single- or multiple-inhaler triple therapy: a retrospective analysis in Spain. In Chest. Elsevier BV. https://doi.org/10.1016/j.chest.2022.06.033