College of Medicine, The Medical University of South Carolina, Charleston, SC, USA.
Data Solutions, Inovalon, Bowie, MD, USA.
Int J Chron Obstruct Pulmon Dis. 2023 Oct 12;18:2245-2256. doi: 10.2147/COPD.S432963. eCollection 2023.
Triple therapy to prevent exacerbations from chronic obstructive pulmonary disease (COPD) is associated with improved health compared to single and dual-agent therapy in some populations. This study assessed the benefits of prompt administration of budesonide/glycopyrrolate/formoterol fumarate (BGF) following a COPD exacerbation.
EROS was a retrospective analysis of people with COPD using the MORE Registry. Inclusion required ≥1 severe, ≥2 moderate, or ≥1 moderate exacerbation while on other maintenance treatment. Within 12 months following the index exacerbation, ≥1 pharmacy claim for BGF was required. Primary outcomes were the rate of COPD exacerbations and healthcare costs for those that received BGF promptly (within 30 days of index exacerbation) versus delayed (31-180 days) and very delayed (181-365 days). The effect of each 30-day delay in initiation of BGF was estimated using a multivariable negative binomial regression model.
2409 patients were identified: 434 prompt, 1187 delayed, and 788 very delayed. The rate (95% CI) of total exacerbations post-index increased as time to BGF initiation increased: prompt 1.52 (1.39-1.66); delayed 2.00 (1.92-2.09); and very delayed 2.30 (2.20-2.40). Adjusting for patient characteristics, each 30-day delay in receiving BGF was associated with a 5% increase in the average number of subsequent exacerbations (rate ratio, 95% CI: 1.05, 1.01-1.08; <0.05). Prompt initiation of BGF was also associated with lower post-index annualized COPD-related costs ($5002 for prompt vs $7639 and $8724 for the delayed and very delayed groups, respectively).
Following a COPD exacerbation, promptly initiating BGF was associated with a reduction in subsequent exacerbations and reduced healthcare utilization and costs.
与单一和双药物治疗相比，三联疗法可预防慢性阻塞性肺疾病（COPD）加重，在某些人群中改善健康状况。本研究评估了 COPD 加重后立即给予布地奈德/格隆溴铵/福莫特罗富马酸盐（BGF）的益处。
EROS 是对 MORE 登记处使用的 COPD 患者进行的回顾性分析。纳入标准为在其他维持治疗期间至少有 1 次重度、≥2 次中度或≥1 次中度加重。在指数加重后 12 个月内，需要≥1 次 BGF 的药房用药。主要结局是那些及时（指数加重后 30 天内）和延迟（31-180 天）和非常延迟（181-365 天）接受 BGF 的 COPD 加重率和医疗保健成本。使用多变量负二项回归模型估计每 30 天延迟开始 BGF 的效果。
共确定了 2409 名患者：434 名及时，1187 名延迟，788 名非常延迟。随着 BGF 起始时间的增加，指数后总的加重率（95%CI）增加：及时为 1.52（1.39-1.66）；延迟为 2.00（1.92-2.09）；非常延迟为 2.30（2.20-2.40）。调整患者特征后，每延迟 30 天接受 BGF 与随后加重的平均数量增加 5%相关（比率比，95%CI：1.05，1.01-1.08；<0.05）。及时开始 BGF 也与指数后年度 COPD 相关成本降低相关（及时为 5002 美元，而延迟和非常延迟组分别为 7639 美元和 8724 美元）。
在 COPD 加重后，及时开始 BGF 可减少随后的加重，并减少医疗保健的利用和成本。
