RTI Health Solutions, Pharmacoepidemiology and Risk Management, Av. Diagonal 605, 9-1, 08028, Barcelona, Spain.
Department of Public Health, University of Southern Denmark, Clinical Pharmacology, Pharmacy, and Environmental Medicine, Odense, Denmark.
Clin Drug Investig. 2022 Apr;42(4):319-331. doi: 10.1007/s40261-022-01120-2. Epub 2022 Mar 15.
Aclidinium bromide was approved in the European Union for the treatment of chronic obstructive pulmonary disease (COPD) in adult patients in 2012 and in a fixed-dose combination with formoterol in 2014. We characterised new users of aclidinium, aclidinium/formoterol and other COPD medications and evaluated off-label prescribing of these medications in three European populations.
We described demographic characteristics, comorbidities, comedications, COPD severity and off-label prescribing of new users of aclidinium, aclidinium/formoterol and other COPD medications in patients with COPD aged ≥ 40 years in the Clinical Practice Research Datalink (CPRD, UK), Danish National Health Databases, and German Pharmacoepidemiological Research Database (GePaRD) between 2015 and 2017.
We included 17,668 new users of aclidinium (CPRD, 4871; Denmark, 2836; GePaRD, 9961) and 14,808 new users of aclidinium/formoterol (CPRD, 2153; Denmark, 2586; GePaRD, 10,069). Study patients were of similar age, except in GePaRD, where users of long-acting beta2-agonists (LABA)/inhaled corticosteroids were younger. Patients had multiple comorbidities and used multiple comedications-most frequently hypertension (50-79%) and short-acting beta2-agonists (26-84%). Aclidinium users in CPRD and long-acting anticholinergics/LABA users in Denmark and GePaRD had the highest frequency of severe/very severe COPD. Off-label prescribing of aclidinium (5.0% [CPRD]-8.9% [Denmark]) and aclidinium/formoterol (2.6% [GePaRD]-3.2% [CPRD]) was low, and the main reason was asthma without a COPD diagnosis.
Aclidinium and aclidinium/formoterol were mostly prescribed according to label, with preference given to older patients with more severe COPD and to patients with a high prevalence of comorbidities and comedication use.
阿地溴铵于 2012 年在欧盟被批准用于治疗成年慢性阻塞性肺疾病(COPD)患者,于 2014 年与福莫特罗联合固定剂量制剂被批准用于治疗成年慢性阻塞性肺疾病(COPD)患者。我们描述了阿地溴铵、阿地溴铵/福莫特罗和其他 COPD 药物的新使用者,并在三个欧洲人群中评估了这些药物的标签外使用情况。
我们描述了年龄≥40 岁的 COPD 患者中,2015 年至 2017 年在临床实践研究数据库(CPRD,英国)、丹麦国家健康数据库和德国药物流行病学研究数据库(GePaRD)中阿地溴铵、阿地溴铵/福莫特罗和其他 COPD 药物新使用者的人口统计学特征、合并症、合并用药、COPD 严重程度和标签外使用情况。
我们纳入了 17668 例阿地溴铵新使用者(CPRD,4871 例;丹麦,2836 例;GePaRD,9961 例)和 14808 例阿地溴铵/福莫特罗新使用者(CPRD,2153 例;丹麦,2586 例;GePaRD,10069 例)。除了 GePaRD 中使用长效β2-激动剂(LABA)/吸入性皮质类固醇的患者年龄较小外,研究患者的年龄相似。患者有多种合并症并使用多种合并用药-最常见的是高血压(50-79%)和短效β2-激动剂(26-84%)。CPRD 中的阿地溴铵使用者和丹麦和 GePaRD 中的长效抗胆碱能药物/LABA 使用者中 COPD 严重/非常严重的患者比例最高。阿地溴铵(5.0%[CPRD]-8.9%[丹麦])和阿地溴铵/福莫特罗(2.6%[GePaRD]-3.2%[CPRD])的标签外使用情况较低,主要原因是哮喘而无 COPD 诊断。
阿地溴铵和阿地溴铵/福莫特罗主要按标签使用,优先用于年龄较大、COPD 较严重和合并症及合并用药较多的患者。