Table 2.
Patient characteristics and disease burden in patients who added to, switched from, or discontinued initial LAMA monotherapya
| Characteristic | Prescriptions for LAMA monotherapy only
|
Added to LAMA monotherapy
|
Switched to an ICS-containing medication
|
Discontinued LAMA monotherapy
|
||||||
|---|---|---|---|---|---|---|---|---|---|---|
| One prescription only
|
Two prescriptions only
|
|||||||||
| 12 months | 24 months | 12 months | 24 months | 12 months | 24 months | 12 months | 24 months | 12 months | 24 months | |
| All patients, n | 2,120 | 2,215 | 312 | 497 | 253 | 313 | 744 | 744 | 382 | 382 |
| Male | 976 (46.0) | 1,015 (45.8) | 139 (44.6) | 222 (44.7) | 117 (46.2) | 147 (47.0) | 394 (53.0) | 394 (53.0) | 182 (47.6) | 182 (47.6) |
| Age, mean (SD) | 56.0 (5.2) | 56.0 (5.2) | 56.2 (5.2) | 56.4 (5.0) | 55.8 (5.6) | 55.2 (5.6) | 54.8 (5.6) | 54.8 (5.6) | 55.8 (5.6) | 55.8 (5.6) |
| Comorbidities | ||||||||||
| Charlson comorbidity index, mean (SD) | 1.6 (2.2) | 1.6 (2.2) | 1.6 (2.2) | 1.8 (2.4) | 1.8 (2.4) | 1.8 (2.2) | 1.6 (2.2) | 1.6 (2.2) | 1.6 (2.6) | 1.6 (2.6) |
| Asthma | 764 (36.0) | 790 (35.7) | 152 (48.7) | 230 (46.3) | 137 (54.2) | 183 (58.5) | 256 (34.4) | 256 (34.4) | 126 (33.0) | 126 (33.0) |
| Myocardial infarction | 181 (8.5) | 182 (8.2) | 29 (9.3) | 47 (9.5) | 31 (12.3) | 36 (11.5) | 83 (11.2) | 83 (11.2) | 41 (10.7) | 41 (10.7) |
| Markers of disease severity | ||||||||||
| Exacerbations | ||||||||||
| None | 1,208 (57.0) | 919 (41.5) | 130 (41.7) | 131 (26.4) | 101 (39.9) | 88 (28.1) | 416 (55.9) | 326 (43.8) | 212 (55.5) | 157 (41.1) |
| 1 | 575 (27.1) | 590 (26.6) | 97 (31.1) | 134 (27.0) | 83 (32.8) | 93 (29.7) | 225 (30.2) | 214 (28.8) | 108 (28.3) | 104 (27.2) |
| ≥2 | 337 (15.9) | 706 (31.9) | 85 (27.2) | 232 (46.7) | 69 (27.3) | 132 (42.2) | 103 (13.8) | 204 (27.4) | 62 (16.2) | 121 (31.7) |
| Moderate exacerbations | ||||||||||
| None | 1,436 (67.7) | 1,178 (53.2) | 177 (56.7) | 201 (40.4) | 141 (55.7) | 138 (44.1) | 503 (67.6) | 412 (55.4) | 259 (67.8) | 204 (53.4) |
| 1 | 472 (22.3) | 542 (24.5) | 79 (25.3) | 132 (26.6) | 64 (25.3) | 77 (24.6) | 168 (22.6) | 187 (25.1) | 86 (22.5) | 92 (24.1) |
| ≥2 | 212 (10.0) | 495 (22.3) | 56 (17.9) | 164 (33.0) | 48 (19.0) | 98 (31.3) | 73 (9.8) | 145 (19.5) | 37 (9.7) | 86 (22.5) |
| Severe exacerbations | ||||||||||
| None | 1,777 (83.8) | 1,682 (75.9) | 240 (76.9) | 326 (65.6) | 193 (76.3) | 217 (69.3) | 627 (84.3) | 589 (79.2) | 309 (80.9) | 286 (74.9) |
| 1 | 275 (13.0) | 379 (17.1) | 57 (18.3) | 118 (23.7) | 54 (21.3) | 71 (22.7) | 103 (13.8) | 123 (16.5) | 58 (15.2) | 66 (17.3) |
| ≥2 | 68 (3.2) | 154 (7.0) | 15 (4.8) | 53 (10.7) | 6 (2.4) | 25 (8.0) | 14 (1.9) | 32 (4.3) | 15 (3.9) | 30 (7.9) |
| Oral corticosteroid use | ||||||||||
| None | 1,409 (66.5) | 1,143 (51.6) | 160 (51.3) | 184 (37.0) | 130 (51.4) | 114 (36.4) | 507 (68.1) | 418 (56.2) | 251 (65.7) | 204 (53.4) |
| 1 | 417 (19.7) | 509 (23.0) | 67 (21.5) | 116 (23.3) | 54 (21.3) | 72 (23.0) | 136 (18.3) | 151 (20.3) | 72 (18.8) | 86 (22.5) |
| ≥2 | 294 (13.9) | 563 (25.4) | 85 (27.2) | 197 (39.6) | 69 (27.3) | 127 (40.6) | 101 (13.6) | 175 (23.5) | 59 (15.4) | 92 (24.1) |
| All-cause hospitalizations | 367 (17.3) | 609 (27.5) | 78 (25.0) | 173 (34.8) | 76 (30.0) | 118 (37.7) | 148 (19.9) | 214 (28.8) | 86 (22.5) | 121 (31.7) |
| Emphysema diagnosis | 256 (12.1) | 363 (16.4) | 48 (15.4) | 108 (21.7) | 36 (14.2) | 48 (15.3) | 56 (7.5) | 74 (9.9) | 45 (11.8) | 60 (15.7) |
| Lower respiratory tract infections | 921 (43.4) | 1,313 (59.3) | 172 (55.1) | 352 (70.8) | 140 (55.3) | 224 (71.6) | 339 (45.6) | 444 (59.7) | 174 (45.5) | 239 (62.6) |
| Oxygen therapy | 245 (11.6) | 327 (14.8) | 68 (21.8) | 131 (26.4) | 44 (17.4) | 53 (16.9) | 74 (9.9) | 87 (11.7) | 44 (11.5) | 52 (13.6) |
| SABD prescriptions | 1,216 (57.4) | 1,476 (66.6) | 231 (74.0) | 409 (82.3) | 187 (73.9) | 252 (80.5) | 345 (46.4) | 403 (54.2) | 193 (50.5) | 228 (59.7) |
| Shortness of breath | 491 (23.2) | 769 (34.7) | 106 (34.0) | 225 (45.3) | 105 (41.5) | 163 (52.1) | 185 (24.9) | 244 (32.8) | 95 (24.9) | 134 (35.1) |
Notes: All values are n (%) unless stated otherwise.
a
Patients had not received ICS at the long-acting bronchodilator index date or during the 12-month prior history.
Abbreviations: ICS, inhaled corticosteroid; LAMA, long-acting muscarinic antagonist; SABD, short-acting bronchodilator; SD, standard deviation.