Real-Life Efficacy of Single-Inhaler Triple Therapy with Budesonide/Glycopyrronium/Formoterol Fumarate in Persistent COPD Users: A Retrospective Database Study

TL;DR

This study shows that using a single-inhaler triple therapy for COPD can reduce hospital visits and improve lung function over time.

Contribution

The study evaluates the real-life long-term efficacy of a specific single-inhaler triple therapy for COPD patients.

Findings

B/F/G therapy reduced emergency room visits and hospitalizations compared to previous treatments.

B/F/G improved lung function (FEV1%) and reduced oral corticosteroid and SABA use.

Patients showed better adherence to B/F/G therapy compared to prior treatments.

Abstract

Background/Objective: Single-inhaler triple therapy (SITT) with budesonide/formoterol/glycopyrronium (B/F/G) is an option for COPD patients with frequent exacerbations. We evaluated its long-term efficacy in real life on emergency room visits/hospitalizations (primary endpoints), lung function, oral corticosteroid (OC), antibiotics and salbutamol (SABA) prescriptions (secondary endpoints). Methods: The aim of this single-center, retrospective observational study was to evaluate, in 65 COPD patients with recurrent exacerbations, the effects of B/F/G treatment after 18–24 months compared to therapies with LABA/LAMA, ICS/LABA, ICS/LABA + LAMA or other SITT taken in the previous 18–24 months. Results: After 22.8 ± 4.6 months, 20.12 ± 4.24 B/F/G packages were prescribed, while packs of other therapies given in the 23.35 ± 4.7 months (p = 0.587) before using B/F/G were 15.58 ± 9.8 (p = 0.0009). Emergency room visits (0.34 ± 0.56) and hospitalizations (0.52 ± 0.81) during about 2 years of B/F/G therapy were lower compared to the ones during pre-B/F/G treatments (0.65 ± 1.2, p = 0.015 and 0.83 ± 1.25, p = 0.019, respectively). After B/F/G treatment, the mean FEV1% value (48.5 ± 16.7%) was higher compared to that measured after the therapies taken before switching to B/F/G (45 ± 15.3%; p = 0.013). Conversely, there were no differences in FVC% values. OCs (2.96 ± 2.6) and SABA (1.41 ± 2.06) packages prescribed during B/F/G were lower than those observed during pre-B/F/G treatments (3.86 ± 2.35, p = 0.026 and 2.48 ± 4.57, p = 0.046, respectively). No differences in antibiotic prescriptions were observed during both therapies. Conclusions: Our real-life evaluation highlighted that B/F/G treatment may be effective, even in the long term, in reducing exacerbations, OC and SABA consumption and in improving lung function in COPD patients with high persistence/adherence to B/F/G compared to other non-persistent inhaled therapies previously taken. Optimizing treatment adherence should be one important goal of COPD patients’ management to maximize the therapy benefits.

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