| Title |
The comparative effectiveness of initiating fluticasone/salmeterol combination therapy via pMDI versus DPI in reducing exacerbations and treatment escalation in COPD: a UK database study
|
|---|---|
| Published in |
International Journal of Chronic Obstructive Pulmonary Disease, August 2017
|
| DOI | 10.2147/copd.s141409 |
| Pubmed ID | |
| Authors |
Rupert Jones, Jessica Martin, Vicky Thomas, Derek Skinner, Jonathan Marshall, Martina Stagno d’Alcontres, David Price |
| Abstract |
Chronic obstructive pulmonary disease (COPD), a complex progressive disease, is currently the third leading cause of death worldwide. One recommended treatment option is fixed-dose combination therapy of an inhaled corticosteroid (ICS)/long-acting β-agonist. Clinical trials suggest pressurized metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs) show similar efficacy and safety profiles in COPD. Real-world observational studies have shown that combination therapy has significantly greater odds of achieving asthma control when delivered via pMDIs. Our aim was to compare effectiveness, in terms of moderate/severe COPD exacerbations and long-acting muscarinic antagonist (LAMA) prescriptions, for COPD patients initiating fluticasone propionate (FP)/salmeterol xinafoate (SAL) via pMDI versus DPI at two doses of FP (500 and 1,000 μg/d) using a real-life, historical matched cohort study. COPD patients with ≥2 years continuous practice data, ≥2 prescriptions for FP/SAL via pMDI/DPI, and no prescription for ICS were selected from the Optimum Patient Care Research Database. Patients were matched 1:1. Rate of moderate/severe COPD exacerbations and odds of LAMA prescription were analyzed using conditional Poisson and logistic regression, respectively. Of 472 patients on 500 μg/d, we observed fewer moderate/severe exacerbations in patients using pMDI (99 [42%]) versus DPI (115 [49%]) (adjusted rate ratio: 0.71; 95% confidence interval: 0.54, 0.93), an important result since the pMDI is not licensed for COPD in the UK, USA, or China. At 1,000 μg/d, we observed lower LAMA prescription for pMDI (adjusted odds ratio: 0.71; 95% confidence interval: 0.55, 0.91), but no difference in exacerbation rates, potentially due to higher dose of ICS overcoming low lung delivery from the DPI. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 50% |
| Singapore | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 66 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 66 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 10 | 15% |
| Researcher | 10 | 15% |
| Student > Master | 9 | 14% |
| Student > Ph. D. Student | 5 | 8% |
| Student > Bachelor | 4 | 6% |
| Other | 7 | 11% |
| Unknown | 21 | 32% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 18 | 27% |
| Pharmacology, Toxicology and Pharmaceutical Science | 7 | 11% |
| Nursing and Health Professions | 5 | 8% |
| Biochemistry, Genetics and Molecular Biology | 2 | 3% |
| Arts and Humanities | 1 | 2% |
| Other | 7 | 11% |
| Unknown | 26 | 39% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 August 2017.
All research outputs
#15,523,434
of 25,382,440 outputs
Outputs from International Journal of Chronic Obstructive Pulmonary Disease
#1,408
of 2,578 outputs
Outputs of similar age
#176,384
of 327,503 outputs
Outputs of similar age from International Journal of Chronic Obstructive Pulmonary Disease
#42
of 78 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. This one is in the 37th percentile – i.e., 37% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,578 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.5. This one is in the 44th percentile – i.e., 44% of its peers scored the same or lower than it.
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We're also able to compare this research output to 78 others from the same source and published within six weeks on either side of this one. This one is in the 46th percentile – i.e., 46% of its contemporaries scored the same or lower than it.