BACKGROUND: Long-acting muscarinic antagonists (LAMA), long-acting β2-agonists (LABA) and fixed dose combinations (FDC) of inhaled corticosteroids (ICS) and LABA are used as inhaled maintenance therapies for COPD. OBJECTIVE: To estimate persistence rates from dispensing patterns of long-acting inhaled drugs for COPD. METHODS: From the PHARMO-database, COPD patients starting LAMA, LABA or LABA-ICS FDC between 2002 and 2006 were selected. Persistence with the initial as well as with any long-acting inhaled drug was determined, defined as time between start and stop of initial/any therapy, allowing ≤ 60-days gaps between refills. For patients who did not continue to receive dispensings of the initial therapy for at least one year, the first change in therapy was determined. RESULTS: The study included 2201 LAMA, 1201 LABA and 4146 LABA-ICS FDC users. Persistence rates with initial therapy alone at 1, 2, and 3 years were 25%, 14%, 8% for LAMA, 21%, 10%, 6% for LABA and 27%, 14%, 8% for LABA-ICS FDC. Of patients who did not persist with LAMA alone for one year, 15% added and 13% switched therapy (both mostly LABA-ICS FDC). Of patients not persisting with LABA alone, 9% added therapy (mostly LAMA) and 31% switched therapy (mostly to LABA-ICS FDC). In patients not persisting with LABA-ICS FDC, add-on and switch occurred equally frequent (11%, mostly LAMA). Persistence rates with any long-acting drug at 1, 2 and 3 years were 36%, 23% and 17% respectively. CONCLUSION: Persistence with the initial as well as with any long-acting inhaled drug in COPD is low, with a substantial proportion of patients changing therapy. Copyright Â
BACKGROUND: Long-acting muscarinic antagonists (LAMA), long-acting β2-agonists (LABA) and fixed dose combinations (FDC) of inhaled corticosteroids (ICS) and LABA are used as inhaled maintenance therapies for COPD. OBJECTIVE: To estimate persistence rates from dispensing patterns of long-acting inhaled drugs for COPD. METHODS: From the PHARMO-database, COPDpatients starting LAMA, LABA or LABA-ICS FDC between 2002 and 2006 were selected. Persistence with the initial as well as with any long-acting inhaled drug was determined, defined as time between start and stop of initial/any therapy, allowing ≤ 60-days gaps between refills. For patients who did not continue to receive dispensings of the initial therapy for at least one year, the first change in therapy was determined. RESULTS: The study included 2201 LAMA, 1201 LABA and 4146 LABA-ICS FDC users. Persistence rates with initial therapy alone at 1, 2, and 3 years were 25%, 14%, 8% for LAMA, 21%, 10%, 6% for LABA and 27%, 14%, 8% for LABA-ICS FDC. Of patients who did not persist with LAMA alone for one year, 15% added and 13% switched therapy (both mostly LABA-ICS FDC). Of patients not persisting with LABA alone, 9% added therapy (mostly LAMA) and 31% switched therapy (mostly to LABA-ICS FDC). In patients not persisting with LABA-ICS FDC, add-on and switch occurred equally frequent (11%, mostly LAMA). Persistence rates with any long-acting drug at 1, 2 and 3 years were 36%, 23% and 17% respectively. CONCLUSION: Persistence with the initial as well as with any long-acting inhaled drug in COPD is low, with a substantial proportion of patients changing therapy. Copyright Â
Authors: Chris M Kozma; Andrew L Paris; Craig A Plauschinat; Terra Slaton; John I Mackowiak Journal: BMC Pulm Med Date: 2011-12-22 Impact factor: 3.317
Authors: Job F M van Boven; Joost J van Raaij; Ruben van der Galiën; Maarten J Postma; Thys van der Molen; P N Richard Dekhuijzen; Stefan Vegter Journal: NPJ Prim Care Respir Med Date: 2014-10-02 Impact factor: 2.871
Authors: David Price; Yumi Asukai; Jaithri Ananthapavan; Bill Malcolm; Amr Radwan; Ian Keyzor Journal: Appl Health Econ Health Policy Date: 2013-06 Impact factor: 2.561
Authors: Mirrian Hilbink; Joyca Lacroix; Linda Bremer-van der Heiden; Aart van Halteren; Martina Teichert; Jan van Lieshout Journal: Trials Date: 2016-06-03 Impact factor: 2.279