Comparative effectiveness of umeclidinium/vilanterol versus indacaterol/glycopyrronium on acute exacerbations in patients with chronic obstructive pulmonary disease in England

G Requena; A Czira; V Banks; R Wood; T Tritton; C Castillo; J Yeap; R Wild; C Compton; M Duarte; K Rothnie; F Herth; A Ismaila

doi:10.1055/s-0043-1761006

Pneumologie, Table of Contents

Pneumologie 2023; 77(S 01): S58-S59
DOI: 10.1055/s-0043-1761006

Abstracts

Comparative effectiveness of umeclidinium/vilanterol versus indacaterol/glycopyrronium on acute exacerbations in patients with chronic obstructive pulmonary disease in England

Authors

G Requena

¹Gsk, R&d Global Medical, Brentford, Middlesex, UK
A Czira

¹Gsk, R&d Global Medical, Brentford, Middlesex, UK
V Banks

²Real-World Evidence, Adelphi Real World, Bollington, Cheshire, UK
R Wood

²Real-World Evidence, Adelphi Real World, Bollington, Cheshire, UK
T Tritton

²Real-World Evidence, Adelphi Real World, Bollington, Cheshire, UK
C Castillo

²Real-World Evidence, Adelphi Real World, Bollington, Cheshire, UK
J Yeap

²Real-World Evidence, Adelphi Real World, Bollington, Cheshire, UK
R Wild

²Real-World Evidence, Adelphi Real World, Bollington, Cheshire, UK
C Compton

¹Gsk, R&d Global Medical, Brentford, Middlesex, UK
M Duarte

¹Gsk, R&d Global Medical, Brentford, Middlesex, UK
K Rothnie

¹Gsk, R&d Global Medical, Brentford, Middlesex, UK
F Herth

³University Hospital Heidelberg; Institute of Internal Medicin III – Pneumology; Thoraxklinik
A Ismaila

⁴Value Evidence and Outcomes, Glaxosmithkline, Collegeville, Pa, Usa; Department of Health Research Methods, Evidence and Impact, Mcmaster University, Hamilton, ON, Canada

Abstract

Full Text

Background Real-world evidence comparing long-acting muscarinic antagonist/long-acting β₂-agonist dual therapies on acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is limited.

Aim and Objectives To compare AECOPD rates in patients newly initiating single-inhaler umeclidinium/vilanterol (UMEC/VI) or indacaterol/glycopyrronium (IND/GLY) in England.

Methods Retrospective cohort study using linked primary and secondary healthcare data. Non-inferiority (NI; 10% pre-defined margin) of UMEC/VI versus IND/GLY on rate of AECOPDs (moderate-to-severe, moderate, severe) was assessed in patients indexed on initiation of single-inhaler UMEC/VI or IND/GLY (01/2015–09/2019) at 6, 12 and 18 months post-index. Inverse probability of treatment weighting (IPTW) was used to balance treatment groups on potential confounders.

Results In 12 031 eligible patients (UMEC/VI: 8753; IND/GLY: 3278), weighted AECOPD rates with UMEC/VI versus IND/GLY were below the pre-specified NI margin at all time points and significantly lower at 6 months for severe AECOPD. Unweighted analyses were similar. Groups were well balanced on potential confounders after IPTW.

Conclusions Newly prescribed UMEC/VI was non-inferior to IND/GLY on rate of moderate-to-severe, moderate, and severe AECOPD in patients with COPD in England.

Funding GSK (study 214887)

Original Abstract presented at the European Respiratory Society (ERS) Conference 2022, Barcelona (Spain), 04th – 06^th September 2022.

Tab. 1 aThe pre-specified NI margin was 10%, which meant that the UMEC/VI cohort could have at most a 10% greater rate of AECOPDs versus IND/GLY (corresponding to a rate ratio of 1.1) to demonstrate NI. AECOPD, acute exacerbation of COPD; CI, confidence interval; COPD, chronic obstructive pulmonary disease; IND/GLY, indacaterol/glycopyrronium; ITT, intent-to-treat; NI, non-inferiority; UMEC/VI, umeclidinium/vilanterol.

Figures

Tab. 1 aThe pre-specified NI margin was 10%, which meant that the UMEC/VI cohort could have at most a 10% greater rate of AECOPDs versus IND/GLY (corresponding to a rate ratio of 1.1) to demonstrate NI. AECOPD, acute exacerbation of COPD; CI, confidence interval; COPD, chronic obstructive pulmonary disease; IND/GLY, indacaterol/glycopyrronium; ITT, intent-to-treat; NI, non-inferiority; UMEC/VI, umeclidinium/vilanterol.