In Taiwan, an analysis of a national insurance claims database shows potential differences in severe acute exacerbation (AEs) among fixed-dose combinations (FDCs) of long-acting muscarinic antagonists (LAMAs) and long-acting β2-agonists (LABAs) for COPD. Cardiovascular events were similar among those newly prescribed fixed-dose combinations (FDCs) of LAMAs and LABAs, but with slightly lower incidence in patients receiving glycopyrronium (GLY)/indacaterol (IND) versus tiotropium (TIO)/olodaterol (OLO).
Participants were 40 years of age or older and were beginning treatment with GLY/IND, umeclidinium (UMEC)/vilanterol (VI), or TIO/OLO. Propensity score matching and Cox regression models provided these insights into outcomes of AE and cardiovascular events: “Among the 44,498 patients identified and included, 15,586 received GLY/IND, 20,460 received UMEC/VI, and 8,452 received TIO/OLO. Baseline characteristics were well balanced after 1:1 matching of UMEC/VI and GLY/IND, 2:1 matching of UMEC/VI and TIO/OLO, and 2:1 matching of GLY/IND and TIO/OLO. Risk of severe AE was lower among patients treated with UMEC/VI or GLY/IND than among those who received TIO/OLO (UMEC/VI vs TIO/OLO: 17.85 vs 29.32 per 100 person-years; hazard ratio, 0.76; 95% CI, 0.68-0.84; GLY/IND vs TIO/OLO: 15.54 vs 25.53 per 100 person-years; hazard ratio, 0.77; 95% CI, 0.67-0.88). In addition, GLY/IND users tended to have a lower risk of cardiovascular events than TIO/OLO users, but the difference dissipated when restricting follow up to a shorter duration.”