Use and persistence of single and multiple inhaler triple therapy prescribed for patients with COPD in France: a retrospective study on THIN database (OPTI study)
Introduction From 2018 single inhaler triple therapy (SITT) became available in France to treat moderate-to-severe chronic obstructive pulmonary disease (COPD). Given its simplified inhaler use compared with multiple inhaler triple therapy (MITT), this therapeutic option has the potential to offer b...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-12-01
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| Series: | BMJ Open Respiratory Research |
| Online Access: | https://bmjopenrespres.bmj.com/content/10/1/e001585.full |
| _version_ | 1797370906295664640 |
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| author | Gaëtan Deslee Andrew Maguire Gabriel Thabut Caroline Fabry-Vendrand Nolwenn Poccardi Caroline Eteve Pitsaer Adrien Coriat Charlotte Renaudat Thomas Pinto |
| author_facet | Gaëtan Deslee Andrew Maguire Gabriel Thabut Caroline Fabry-Vendrand Nolwenn Poccardi Caroline Eteve Pitsaer Adrien Coriat Charlotte Renaudat Thomas Pinto |
| author_sort | Gaëtan Deslee |
| collection | DOAJ |
| description | Introduction From 2018 single inhaler triple therapy (SITT) became available in France to treat moderate-to-severe chronic obstructive pulmonary disease (COPD). Given its simplified inhaler use compared with multiple inhaler triple therapy (MITT), this therapeutic option has the potential to offer benefit in terms of improved persistence and adherence. Given the lack of real-world evidence of the effectiveness of triple therapy, this study was designed to evaluate the use of MITT and SITT in France and compare persistence.Methods A retrospective cohort study was performed. Patients with COPD who initiated triple therapy between 1 July 2017 and 31 December 2019 were included from The Health Improvement Network, a large electronic medical database in France, which includes pharmacy data. A 60-day treatment gap defined discontinuation and thereby persistence.Results A total of 3134 patients initiated triple therapy for COPD in the study period, among them 485 with SITT. In 2019, the rate of use of SITT was 28.2%. The mean age (67.3 years) and sex (44.2% female) of patients initiating triple therapy was similar between MITT and SITT, and most patients had escalated from dual therapy (84.1%). However, SITT was more frequently initiated by a pulmonologist (59.8%) and a higher prevalence of comorbid asthma was observed for SITT (47.0% vs 37.9%). Persistence was assessed among patients who did not discontinue after a single dispensation of triple therapy (n=1674). Median persistence was 181 days for SITT and 135 days for MITT, and the covariate-adjusted HR for persistence was 1.47 (p<0.001) and the estimated persistence at 1 year was 33% for SITT compared with 18% for MITT.Discussion This study suggests that persistence was higher for the patients treated with SITT compared with MITT in France. Moreover, most patients initiated with triple therapy were previously treated with dual therapy and had exacerbations in the previous year. |
| first_indexed | 2024-03-08T18:12:12Z |
| format | Article |
| id | doaj.art-f7c4d74960104563a812915b7b0ff40f |
| institution | Directory Open Access Journal |
| issn | 2052-4439 |
| language | English |
| last_indexed | 2024-03-08T18:12:12Z |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Respiratory Research |
| spelling | doaj.art-f7c4d74960104563a812915b7b0ff40f2024-01-01T05:45:08ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392023-12-0110110.1136/bmjresp-2022-001585Use and persistence of single and multiple inhaler triple therapy prescribed for patients with COPD in France: a retrospective study on THIN database (OPTI study)Gaëtan Deslee0Andrew Maguire1Gabriel Thabut2Caroline Fabry-Vendrand3Nolwenn Poccardi4Caroline Eteve Pitsaer5Adrien Coriat6Charlotte Renaudat7Thomas Pinto8Service de Pneumologie, INSERM UMRS-1250, CHU de Reims, Université Reims Champagne-Ardenne, CHU de Reims, Reims, FranceEpiFocus ltd, London, UKAstraZeneca, Courbevoie, FranceAstraZeneca, Paris, FranceAstraZeneca, Courbevoie, FranceCegedim Group, Boulogne-Billancourt, FranceCegedim Group, Boulogne-Billancourt, FranceCegedim Group, Boulogne-Billancourt, FranceMédecin généraliste, Chef de clinique universitaire, Université de Paris, Paris, FranceIntroduction From 2018 single inhaler triple therapy (SITT) became available in France to treat moderate-to-severe chronic obstructive pulmonary disease (COPD). Given its simplified inhaler use compared with multiple inhaler triple therapy (MITT), this therapeutic option has the potential to offer benefit in terms of improved persistence and adherence. Given the lack of real-world evidence of the effectiveness of triple therapy, this study was designed to evaluate the use of MITT and SITT in France and compare persistence.Methods A retrospective cohort study was performed. Patients with COPD who initiated triple therapy between 1 July 2017 and 31 December 2019 were included from The Health Improvement Network, a large electronic medical database in France, which includes pharmacy data. A 60-day treatment gap defined discontinuation and thereby persistence.Results A total of 3134 patients initiated triple therapy for COPD in the study period, among them 485 with SITT. In 2019, the rate of use of SITT was 28.2%. The mean age (67.3 years) and sex (44.2% female) of patients initiating triple therapy was similar between MITT and SITT, and most patients had escalated from dual therapy (84.1%). However, SITT was more frequently initiated by a pulmonologist (59.8%) and a higher prevalence of comorbid asthma was observed for SITT (47.0% vs 37.9%). Persistence was assessed among patients who did not discontinue after a single dispensation of triple therapy (n=1674). Median persistence was 181 days for SITT and 135 days for MITT, and the covariate-adjusted HR for persistence was 1.47 (p<0.001) and the estimated persistence at 1 year was 33% for SITT compared with 18% for MITT.Discussion This study suggests that persistence was higher for the patients treated with SITT compared with MITT in France. Moreover, most patients initiated with triple therapy were previously treated with dual therapy and had exacerbations in the previous year.https://bmjopenrespres.bmj.com/content/10/1/e001585.full |
| spellingShingle | Gaëtan Deslee Andrew Maguire Gabriel Thabut Caroline Fabry-Vendrand Nolwenn Poccardi Caroline Eteve Pitsaer Adrien Coriat Charlotte Renaudat Thomas Pinto Use and persistence of single and multiple inhaler triple therapy prescribed for patients with COPD in France: a retrospective study on THIN database (OPTI study) BMJ Open Respiratory Research |
| title | Use and persistence of single and multiple inhaler triple therapy prescribed for patients with COPD in France: a retrospective study on THIN database (OPTI study) |
| title_full | Use and persistence of single and multiple inhaler triple therapy prescribed for patients with COPD in France: a retrospective study on THIN database (OPTI study) |
| title_fullStr | Use and persistence of single and multiple inhaler triple therapy prescribed for patients with COPD in France: a retrospective study on THIN database (OPTI study) |
| title_full_unstemmed | Use and persistence of single and multiple inhaler triple therapy prescribed for patients with COPD in France: a retrospective study on THIN database (OPTI study) |
| title_short | Use and persistence of single and multiple inhaler triple therapy prescribed for patients with COPD in France: a retrospective study on THIN database (OPTI study) |
| title_sort | use and persistence of single and multiple inhaler triple therapy prescribed for patients with copd in france a retrospective study on thin database opti study |
| url | https://bmjopenrespres.bmj.com/content/10/1/e001585.full |
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