Initiation of single-inhaler COPD triple therapy improved adherence compared to multiple inhalers

March 30, 2022

2 minute read

Disclosures: The study was funded by GlaxoSmithKline. Mannino claims to have been an employee of GlaxoSmithKline. Please see the study for relevant financial information from all other authors.

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According to a real-world study, COPD patients who started single-inhaler triple therapy had improved inhaler adherence and persistence compared to multiple-inhaler triple therapy users.

Researchers conducted a retrospective analysis of 2,782 COPD patients (mean age, 60.6 years; 54.5% female) in the IQVIA PharMetrics Plus claims database who started triple therapy with fluticasone furoate , umeclidinium and vilanterol (Trelegy Ellipta; GlaxoSmithKline and Innoviva) from September 2017 to June 2019. The researchers also examined data from 7,160 patients using multiple inhaler triple therapy (mean age, 60.4 years 52.1% women). All patients were at least 40 years old and had at least 12 months of continuous insurance coverage before initiation and at least 6 months of coverage after initiation.

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At 6 months, patients who started single-inhaler triple therapy had higher inhaler adherence, with a mean proportion of days covered of 0.66 versus 0.48 (P

The researchers also analyzed 1,337 single-inhaler triple therapy users and 3,442 multiple-inhaler triple therapy users with 12 months or more of follow-up data in a subgroup analysis. In the subgroup analysis, single inhaler triple therapy users had a higher proportion of days covered compared to multiple inhaler triple therapy users (0.6 versus 0.4; P

Compared to multiple inhaler triple therapy, single inhaler triple therapy users were also twice as likely to adhere to their inhaler therapy (22.3% vs. 46.5%; RR=2.08; 95% CI %, 1.85-2.3; P P P P

In the subgroup analysis, after 12 months, more patients who initiated single-inhaler triple therapy persisted in their treatment compared to patients using multiple-inhaler triple therapy (35.7% vs. 13.9%; HR = 1.91, 95% CI, 1.81-2.01; P

“Thus, the improvements in adherence and persistence observed in this study for patients initiating a single inhaler of fluticasone furoate/umeclidinium/vilanterol are very promising. Further studies are needed to understand how the observed improvements in “adherence and persistence with fluticasone furoate/umeclidinium/vilanterol translates into clinical and economic benefits”, David Mannino, MD, respiratory medicine expert at GlaxoSmithKline, and his colleagues wrote in respiratory medicine.