Authors (including presenting author) :
Chan KH
Affiliation :
Pharmacy, Princess Margaret Hospital
Introduction :
Chronic Obstructive Pulmonary Disease (COPD) is currently the fourth leading cause of death in the world and is projected to be the third leading cause of death in 2030. The use of long acting muscarinic antagonist (LAMA) and long acting beta-2 agonist (LABA) combination is recommended by the 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) Report for Group B patients with persistent breathlessness on monotherapy and in Group C patients with persistent exacerbations.
Objectives :
This study aimed to compare the number of Accident and Emergency department (AE) visit and hospitalization due to COPD exacerbations among patients initiated with different LAMA/LABA combinations.
Methodology :
This is a retrospective review conducted at Princess Margaret Hospital (PMH). All outpatients aged 18 years or older with clinical history of COPD as documented in Clinical Management System (CMS) initiated with LAMA/LABA combinations from 1st February 2015 to 31st July 2016 were included in the study. Demographic data and study parameters regarding AE visit and hospitalization due to COPD exacerbations in 1 year after initiation of LAMA/LABA combination were collected from the study population via electronic Patient Record (ePR). Incidence of exacerbation related events (e.g. hospitalization related to COPD exacerbation) were compared among patients using different LAMA/LABA combinations using chi-square test with Statistical Package for Social Science (SPSS) Version 25. Statistical comparisons were based on 2-tailed tests.
Result & Outcome :
A total of 252 patients were initiated with the study drug combinations: Anoro Ellipta (Umeclidinium 62.5 mcg/Vilanterol 25 mcg), Ultibro (Indacaterol 110mcg/Glycopyrronium 50mcg), and other LAMA/LABA combinations. The mean number of AE visits and hospitalizations due to COPD exacerbation in 1 year after the initiation of LAMA/LABA combination was 1.31 and 1.17 respectively in the whole study population. The study population was stratified into “Fixed-dose combination” and “Combination of 2 separate inhalation products”. Patients initiated with “Fixed-dose combination” had a mean number of AE visits of 1.08 in 1 year after initiation of study drug combination, compared to 1.38 in those initiated with “Combination of 2 separate inhalation products” (p = 0.258). For the number of hospitalizations, patients initiated with “Fixed-dose combination” had a mean number of hospitalizations of 0.85 in 1 year after initiation of study drug combination, compared to 1.27 in those initiated with “Combination of 2 separate inhalation products” (p = 0.064).
Co-location with:
