In a cohort study, patients with chronic obstructive pulmonary disease (COPD) in a real-world clinical practice setting combined long-acting beta2-agonists and long-acting muscarinic antagonists (LABA-LAMA) inhalers appeared to be as effective as the combination of LABA with inhaled corticosteroids (LABA-ICS) inhalers in preventing COPD exacerbations. Patients aged ≥55 years initiating LABA-LAMA on the same day (no ICS), were matched on time-conditional high-dimensional propensity scores with patients initiating LABA-ICS on the same day (no LAMA) and followed for 1 year for the occurrence of a moderate or severe COPD exacerbation and severe pneumonia. Researchers found:
- The cohort included 1,977 initiators of LABA-LAMA matched to 1,977 initiators of LABA-ICS.
- Hazard ratio of moderate or severe COPD exacerbation was associated with LABA-LAMA initiation, relative to LABA-ICS initiation, was 1.04, while for a severe exacerbation it was 0.94.
- The incidence of severe pneumonia requiring hospitalization was lower with LABA-LAMA initiation.
Suissa S, Dell’Aniello S, Ernst P. Comparative effectiveness and safety of LABA-LAMA versus LABA-ICS treatment of COPD in real world clinical practice. [Published online ahead of print March 26, 2019]. Chest. doi:10.1016/j.chest.2019.03.005.