Characteristics of Patients Initiated on Budesonide/Glycopyrronium Bromide/Formoterol Fumarate Single Inhaler Triple Therapy for the Treatment of Chronic Obstructive Pulmonary Disease: A Population-Based Observational Study.

Abstract

Background: Budesonide/glycopyrronium bromide/formoterol fumarate (BUD/GLY/FOR) single inhaler triple therapy became available to prescribe to patients with severe chronic obstructive pulmonary disease (COPD) in France in 2021. The characteristics of patients prescribed BUD/GLY/FOR triple therapy and guideline adherence have not been previously described in France.

Objective: To describe the characteristics of COPD patients initiated on BUD/GLY/FOR triple therapy, assess adherence to COPD management guidelines, and explore any differences by prescribing physician.

Materials and methods: A cross-sectional study using data from The Health Improvement Network (THIN^®) France database was conducted. Patients with ≥2 recorded diagnostic codes for COPD were included. Demographic characteristics, comorbidities, management, COPD-related characteristics, and guideline adherence (Société de Pneumologie de Langue Française (SPLF); Haute Autorité de Santé (HAS)), stratified by initiating physician speciality (general practitioner (GP) or pulmonologist) were described.

Results: A total of 263 patients initiating BUD/GLY/FOR triple therapy were included. Mean (SD) age was 68.8 (11.8) years; 53.6% were male. Mean (SD) COPD duration was 6.4 (5.5) years. Comorbidities were common, with slightly more cardiometabolic and mental health conditions recorded in the GP-initiated group, and more comorbid respiratory conditions recorded in the pulmonologist-initiated group. About 77.2% (n=203) of patients had at least one moderate or severe exacerbation in the 12 months before initiation. About 86.3% had a previous record of dual (n=117, 44.5%) or triple (n=110, 41.8%) therapy. About 68.8% had been initiated on BUD/GLY/FOR triple therapy in line with SPLF guidelines (62.4% and 72.4% in the GP- and pulmonologist-initiated groups, respectively); among those with a record of COPD severity, 75.2% were initiated in line with HAS guidelines (69.2% and 76.3% in the GP- and pulmonologist-initiated groups, respectively).

Conclusion: The majority of COPD patients are prescribed BUD/GLY/FOR triple therapy in accordance with current treatment guidelines, irrespective of whether the therapy is prescribed by a general practitioner or a pulmonologist.