Prompt initiation of single-inhaler budesonide/glycopyrrolate/formoterol fumarate (BGF) following a COPD exacerbation reduces exacerbations and cardiopulmonary risk in patients with COPD: insights from the MITOS EROS+CP study in the United States.

IF 2.2 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Current Medical Research and Opinion Pub Date : 2025-07-01 Epub Date: 2025-08-20 DOI:10.1080/03007995.2025.2545493
Michael Pollack, Joseph Tkacz, Jill Schinkel, Barnabie Agatep, Edward Portillo, Hayley D Germack, Michael G Crooks, Charlie Strange, Jonathan Marshall, Hana Mullerova
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引用次数: 0

Abstract

Objective: To investigate the association between the timing of single-inhaler triple therapy Budesonide/Glycopyrrolate/Formoterol Fumarate (BGF) initiation following a COPD exacerbation and subsequent COPD exacerbations and non-fatal cardiopulmonary events.

Methods: This was a retrospective analysis of the Inovalon MORE2 Registry and Medicare Fee-for-Service claims databases spanning July 1, 2019 to May 31, 2023. Eligible patients with COPD were aged ≥40 years, and initiated BGF treatment within 1-year of a qualifying COPD exacerbation (index event) with 12 months of baseline enrollment. Secondary study populations included patients escalating from dual therapy and patients with comorbid asthma. Negative binomial regressions were used to evaluate the adjusted risks for subsequent annualized exacerbations and cardiopulmonary events based on the timing of BGF initiation: prompt (≤30 days), delayed (31-180 days), and very delayed (181-365 days).

Results: Among 25,603 patients included, 14.8% were prompt, 37.7% delayed, and 47.5% very delayed initiators. Mean age was 60.3 years and 64.3% were female. Among the 10,630 cardiopulmonary events observed, 63% were cardiovascular-related. During follow-up, prompt initiators had 25.7% (adjIRD: 0.74 [0.72-0.77]) and 30.6% (adjIRVD: 0.69 [0.67-0.72]) lower risk of subsequent annualized exacerbations compared to delayed and very delayed initiators, respectively. Additionally, prompt initiators had 16.3% (adjIRD: 0.84 [0.77-0.91]) and 17.5% (adjIRVD: 0.83 [0.77-0.89]) lower risk of cardiopulmonary events, respectively. Similar results were observed for patients escalating from dual therapy and those with asthma.

Conclusions: Prompt initiation of BGF following a COPD exacerbation, including among patients previously managed with dual therapy, was associated with lower annualized rates of cardiopulmonary and exacerbation events.

美国MITOS EROS + CP研究的见解:COPD加重后立即开始使用布地奈德/甘罗酸酯/富马酸福莫特罗(BGF)单吸入剂可降低COPD患者的加重和心肺风险。
目的:探讨布地奈德/甘炔罗酸酯/富马酸福莫特罗(BGF)单吸入器三联治疗在COPD加重后的起始时间与随后的COPD加重和非致死性心肺事件之间的关系。方法:回顾性分析2019年7月1日至2023年5月31日Inovalon MORE2注册表和医疗保险服务收费索赔数据库。符合条件的COPD患者年龄≥40岁,在符合条件的COPD加重(指数事件)后1年内开始BGF治疗,基线入组时间为12个月。次要研究人群包括从双重治疗升级的患者和合并哮喘的患者。采用负二项回归来评估基于BGF起始时间:提示(≤30天)、延迟(31-180天)和非常延迟(181-365天)的随后年化恶化和心肺事件的调整风险。结果:纳入的25603例患者中,14.8%为及时启动,37.7%为延迟启动,47.5%为非常延迟启动。平均年龄60.3岁,女性64.3%。在观察到的10,630例心肺事件中,63%与心血管相关。随访期间,与延迟启动者和非常延迟启动者相比,及时启动者随后的年化恶化风险分别降低25.7% (adjIRD: 0.74[0.72-0.77])和30.6% (adjIRVD: 0.69[0.67-0.72])。此外,及时启动者的心肺事件风险分别降低16.3% (adjIRD: 0.84[0.77-0.91])和17.5% (adjIRVD: 0.83[0.77-0.89])。从双重治疗升级的患者和哮喘患者也观察到类似的结果。结论:COPD加重后迅速启动BGF,包括先前接受双重治疗的患者,与较低的年化心肺和加重事件发生率相关。
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来源期刊
Current Medical Research and Opinion
Current Medical Research and Opinion 医学-医学:内科
CiteScore
4.40
自引率
4.30%
发文量
247
审稿时长
3-8 weeks
期刊介绍: Current Medical Research and Opinion is a MEDLINE-indexed, peer-reviewed, international journal for the rapid publication of original research on new and existing drugs and therapies, Phase II-IV studies, and post-marketing investigations. Equivalence, safety and efficacy/effectiveness studies are especially encouraged. Preclinical, Phase I, pharmacoeconomic, outcomes and quality of life studies may also be considered if there is clear clinical relevance
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