Pneumologie 2023; 77(S 01): S79
DOI: 10.1055/s-0043-1761055
Abstracts

Effects of triple therapy in patients of GOLD group C and D: Results from the observational COPD cohort COSYCONET

J Zader
1   Charité Berlin
,
R Jörres
2   Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin; Klinikum der Universität München; LMU München
,
I Mayer
1   Charité Berlin
,
P Alter
3   Universitätsklinikum Gießen U. Marburg, Standort Marburg; Klinik für Innere Medizin, Pneumologie und Intensivmedizin
,
R Bals
4   Direktor der Klinik für Innere Medizin V; Universitätsklinikum des Saarlandes, Gebäude 91; Innere Medizin V
,
H Watz
5   Pneumologisches Forschungsinstitut; an der Lungenclinic Grosshansdorf; Pulmonary Research Institute at Lungenclinic Grosshansdorf
,
P Mertsch
6   Klinikum der Universität München; Medizinische Klinik und Poliklinik V
,
K Rabe
7   Lungenclinic Grosshansdorf und Klinik für Innere Medizin, Christian-Albrechts Universität, Kiel; Zentrum Für Pneumologie Und Thoraxchirurgie; Pneumologie
,
F Herth
8   University Hospital Heidelberg; Institute of Internal Medicin III – Pneumology; Thoraxklinik
,
F Trudzinski
9   Thoraxklinik Heidelberg; Pneumologie und Beatmungsmedizin
,
T Welte
10   Klinik für Pneumologie
,
H Kauczor
11   Klinik für Diagnostische und Interventionelle Radiologie
,
J Behr
12   Klinikum der LMU München; Medizinische Klinik und Poliklinik V; Comprehensive Pneumology Center
,
J Walter
13   Department of Medicine V, University Hospital, LMU Munich
,
C Vogelmeier
14   Department of Medicine, Pulmonary and Critical Care Medicine, Philipps University of Marburg; Deutsches Zentrum für Lungenforschung (Dzl); Klinik für Innere Medizin, Schwerpunkt Pneumologie
,
K Kahnert
15   Medizinische Klinik und Poliklinik V
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    Background Randomized controlled trials found beneficial effects of inhaled triple therapy in patients with chronic obstructive pulmonary disease (COPD) and high risk of exacerbations. We studied whether such effects could also be detected in patients under continuous treatment in an observational, real-life setting.

    Methods Data from visit 1 (baseline) and visit 3 (18-month follow up) from the COPD cohort COSYCONET were used, specifically patients of GOLD grades 1-4 and GOLD groups C/D at both visits (n=258). Therapy groups were defined as having triple therapy at both visits (triple always) vs no triple therapy at both visits (triple not always). The measured variables were divided into predictors of triple therapy and outcomes. Comparisons were performed using multiple regression analysis, propensity score matching and inverse probability weighting to adjust for differences between groups.

    Results In total 258 patients were eligible for this analysis (triple always n=162, triple not always n=96). Without matching, patients with triple-therapy showed significant (p<0.05) impairments including lung function, quality of life and symptom burden. After adjustment and matching, the differences in the COPD characteristics were no more significant or reversed in sign. Total direct health care costs were still elevated after matching but no significant differences between groups remained. This was due to a reduction in inpatient costs, while costs of total/respiratory medication were only slightly reduced.

    Conclusion Naively and without matching, patients with triple therapy showed multiple impairments in clinical and functional state, as well as treatment costs. After matching, most differences were reduced or reverted and no more statistically significant, except for medication costs. As far as conclusions can be drawn from purely observational data involving different devices and formulations of triple-therapy, our findings hint towards beneficial effects of triple therapy under continuous, long-term treatment.


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    Publication History

    Article published online:
    09 March 2023

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