Lung function and treatment patterns of symptomatic patients with moderate COPD in the CRYSTAL study

Background: Differences in treatment patterns in symptomatic COPD patients with moderate airflow limitation have been shown in real-life studies. Methods: CRYSTAL is a prospective multicenter randomized pragmatic clinical trial addressing the efficacy and safety of the direct switch from previous therapy to glycopyrronium or indacaterol/glycopyrronium fixed dose combination over 12 weeks in non-exacerbating symptomatic patients (mMRC≥1) with FEV 1 50-80% pred. We report baseline lung function and COPD treatment of patients recruited in the first year in the CRYSTAL study. Results: 3183 patients were recruited, of which 39.3% had mMRC≥2. Patients with mMRC≥2 were more often female and had lower FEV 1 values. Most commonly used treatments in this population were LAMA, LABA and LABA/ICS (Table). LABA/ICS were more commonly used in patients with mMRC≥2, whereas LAMA in those with mMRC=1. Conclusion: In the clinical practice population of the CRYSTAL trial, differences in COPD treatments were observed between less and more symptomatic patients. Approximately 1 out of 4 of these non-exacerbating patients with moderate airflow limitation were on ICS, in contrast to guidelines.