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COPD and New Use of Combination Inhalers

Among new users of combination medication inhalers for chronic obstructive pulmonary disease (COPD), those on long-acting muscarinic antagonists (LAMAs) with long-acting β-agonists (LABAs) had a reduced incidence of exacerbations and pneumonia hospitalizations compared with new users of inhaled corticosteroids (ICSs) and LABAs, a study shows.

Patients with a diagnosis of COPD and a new prescription for a combination LAMA-LABA or ICS-LABA inhaler between 2014 and 2019 in the Optum’s Clinformatics Data Mart were followed until Feb. 2021 to Mar. 2023. Results based on a primary effectiveness outcome of first moderate or severe COPD exacerbation and a primary safety outcome of first pneumonia hospitalization were as follows: “Among 137,833 patients (mean [SD] age, 70.2 [9.9] years; 69,530 [50.4%] female) (107,004 new ICS-LABA users and 30,829 new LAMA-LABA users), 30,216 matched pairs were identified for the primary analysis. Compared with ICS-LABA use, LAMA-LABA use was associated with an 8% reduction in the rate of first moderate or severe COPD exacerbation (HR, 0.92; 95% CI, 0.89-0.96) and a 20% reduction in the rate of first pneumonia hospitalization (HR, 0.80; 95% CI, 0.75-0.86). These findings were robust across a range of prespecified subgroup and sensitivity analyses.”

Source: JAMA Internal Medicine