PMID- 34530132 OWN - NLM STAT- MEDLINE DCOM- 20220127 LR - 20220127 IS - 1522-9629 (Electronic) IS - 1094-5539 (Linking) VI - 71 DP - 2021 Dec TI - Which LABA/LAMA should be chosen in COPD patients in real life? PG - 102076 LID - S1094-5539(21)00088-2 [pii] LID - 10.1016/j.pupt.2021.102076 [doi] AB - BACKGROUND: Given COPD heterogeneity, we do not know if some LABA/LAMAs are more suitable for some COPD phenotypes. This real-life database study aimed to evaluate retrospectively the 4 LABA/LAMA effectiveness and highlight possible specificities that could better guide us in choosing the right LABA/LAMA to be used. METHODS: We searched for subjects (1,779) adherent to umeclidinium/vilanterol (UM/VI), indacaterol/glycopyrronium (IND/GLY), aclidinium/formoterol (ACLI/FOR) and tiotropium/olodaterol (TIO/OLO) treatments in our prescribing/dispensing database. Prescriptions for systemic corticosteroids (SC), antibiotics and salbutamol during one year of LABA/LAMA treatment were analyzed. RESULTS: A better adherence was found in individuals taking IND/GLY (10.42 +/- 1.86 packages/year) compared with UM/VI (10.09 +/- 1.9; p = 0.008), ACLI/FOR (9.8 +/- 1.8; p = 0.001) and TIO/OLO (10.1 +/- 2.1; p = 0.047). The number of patients that were prescribed at least one package of SC/year and their package numbers/year were similar in males/females, across age groups and in "non-frequent exacerbators" with the 4 LABA/LAMAs. More SC were taken by frequent exacerbators, whereas fewer SC/antibiotic packages were prescribed to subjects aged >80 years with all treatments. In patients treated with ACLI/FOR or TIO/OLO, lower risks to having antibiotic prescriptions were observed when UM/VI (0.698[0.516-0.945] and 0.696[0.491-0.985; p = 0.020 and p = 0.041) and IND/GLY (0.597[0.445-0.802] and 0.595[0.423-0.836]; p = 0.001 and p = 0.003) were considered as landmarks. Lower risks for salbutamol prescriptions were detected with UM/VI (0.678[0.480-0.958]; p = 0.027) and TIO/OLO (0.585[0.365-0.937]; p = 0.026) when ACLI/FOR was used as a reference. CONCLUSION: According to our retrospective database study, each LABA/LAMA could have a specific efficacy profile in COPD that might be considered for personalized therapy. However, head-to-head targeted trials aimed to assess the impact of different LABA/LAMAs on COPD are needed to confirm/disprove such results. CI - Copyright (c) 2021 Elsevier Ltd. All rights reserved. FAU - Sposato, Bruno AU - Sposato B AD - Pneumology Department, Azienda USL Toscana Sud-Est, "Misericordia" Hospital, Grosseto, Italy; Experimental Medicine and Systems, "PhD Program" Department of Systems Medicine University of Rome "Tor Vergata", Italy. Electronic address: bru.sposato@gmail.com. FAU - Petrucci, Elisa AU - Petrucci E AD - Department of Pharmaceutical Medicine, Azienda USL Toscana Sud-Est, "Misericordia" Hospital, Grosseto, Italy. FAU - Serafini, Andrea AU - Serafini A AD - Medical Management Department, Azienda USL Toscana Sud-Est, "Misericordia" Hospital, Grosseto, Italy. FAU - Lena, Fabio AU - Lena F AD - Department of Pharmaceutical Medicine, Azienda USL Toscana Sud-Est, "Misericordia" Hospital, Grosseto, Italy. FAU - Lacerenza, Leonardo Gianluca AU - Lacerenza LG AD - Department of Pharmaceutical Medicine, Azienda USL Toscana Sud-Est, "Misericordia" Hospital, Grosseto, Italy. FAU - Montagnani, Andrea AU - Montagnani A AD - Department of Internal Medicine and Specialties, USL Tuscany South-East, Italy. FAU - Alessandri, Massimo AU - Alessandri M AD - Department of Internal Medicine and Specialties, USL Tuscany South-East, Italy. FAU - Cresti, Alberto AU - Cresti A AD - Cardiology Department, "Misericordia" Hospital, Grosseto, USL Tuscany South-East, Italy. FAU - Scala, Raffaele AU - Scala R AD - Pulmonology and Respiratory Intensive Care Unit, S Donato Hospital, Arezzo, Italy. FAU - Rogliani, Paola AU - Rogliani P AD - Experimental Medicine and Systems, "PhD Program" Department of Systems Medicine University of Rome "Tor Vergata", Italy; Respiratory Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy. FAU - Ricci, Alberto AU - Ricci A AD - Division of Pneumology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, AOU Sant'Andrea, Rome, Italy. FAU - Perrella, Antonio AU - Perrella A AD - Pneumology Department, Azienda USL Toscana Sud-Est, "Misericordia" Hospital, Grosseto, Italy. FAU - Scalese, Marco AU - Scalese M AD - Institute of Clinical Physiology, National Research Council, Pisa, Italy. LA - eng PT - Journal Article DEP - 20210913 PL - England TA - Pulm Pharmacol Ther JT - Pulmonary pharmacology & therapeutics JID - 9715279 RN - 0 (Adrenergic beta-2 Receptor Agonists) RN - 0 (Bronchodilator Agents) RN - 0 (Drug Combinations) RN - 0 (Muscarinic Antagonists) RN - V92SO9WP2I (Glycopyrrolate) SB - IM MH - Administration, Inhalation MH - *Adrenergic beta-2 Receptor Agonists/therapeutic use MH - Bronchodilator Agents/therapeutic use MH - Drug Combinations MH - Female MH - Glycopyrrolate/therapeutic use MH - Humans MH - Male MH - Muscarinic Antagonists/therapeutic use MH - *Pulmonary Disease, Chronic Obstructive/drug therapy MH - Retrospective Studies MH - Treatment Outcome OTO - NOTNLM OT - Antibiotic OT - COPD OT - Exacerbation OT - Fixed-dose combination OT - LABA OT - LAMA OT - Long-acting muscarinic antagonist OT - Long-acting beta2-agonists OT - Salbutamol OT - Systemic corticosteroid EDAT- 2021/09/17 06:00 MHDA- 2022/01/28 06:00 CRDT- 2021/09/16 20:15 PHST- 2021/04/04 00:00 [received] PHST- 2021/08/16 00:00 [revised] PHST- 2021/09/08 00:00 [accepted] PHST- 2021/09/17 06:00 [pubmed] PHST- 2022/01/28 06:00 [medline] PHST- 2021/09/16 20:15 [entrez] AID - S1094-5539(21)00088-2 [pii] AID - 10.1016/j.pupt.2021.102076 [doi] PST - ppublish SO - Pulm Pharmacol Ther. 2021 Dec;71:102076. doi: 10.1016/j.pupt.2021.102076. Epub 2021 Sep 13.