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Three-year dispensing patterns with long-acting inhaled drugs in COPD: a database analysis
Fernie Penning-van Beest1, Myrthe van Herk-Sukel, Rupert Gale
1PHARMO Institute, PO Box 85222, 3508 AE Utrecht, Utrecht, The Netherlands. fernie.penning@pharmo.nl
Respiratory Medicine
|August 14, 2010
Summary
Persistence with long-acting inhaled COPD therapies, including LAMA, LABA, and ICS/LABA FDC, is low. Many patients switch treatments, highlighting challenges in maintaining consistent COPD management.
Area of Science:
- Pulmonology
- Pharmacology
- Real-world evidence
Background:
- Long-acting muscarinic antagonists (LAMA), long-acting β2-agonists (LABA), and fixed-dose combinations (FDC) of inhaled corticosteroids (ICS) and LABA are standard inhaled maintenance therapies for COPD.
- Understanding patient adherence to these therapies is crucial for effective COPD management.
Purpose of the Study:
- To estimate persistence rates with long-acting inhaled COPD medications using dispensing data.
- To analyze patterns of therapy changes among COPD patients initiating LAMA, LABA, or LABA-ICS FDC.
Main Methods:
- Retrospective analysis of the PHARMO-database for COPD patients initiating LAMA, LABA, or LABA-ICS FDC between 2002-2006.
- Persistence defined by continuous dispensing, allowing for a ≤60-day gap. Therapy changes (add-on or switch) were recorded for non-persistent patients.
Main Results:
- Initial persistence rates at 1, 2, and 3 years were low across all drug classes (e.g., LAMA: 25%, 14%, 8%).
- Significant proportions of patients switched or added therapies, often to LABA-ICS FDC, after failing to persist with initial treatment.
- Overall persistence with any long-acting inhaled drug at 1, 2, and 3 years was 36%, 23%, and 17% respectively.
Conclusions:
- Persistence with initial and any long-acting inhaled therapy for COPD is notably low.
- A substantial number of COPD patients alter their long-acting inhaled medication regimens, indicating potential issues with treatment adherence or effectiveness.
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