Treatment patterns of COPD patients in France: A retrospective analysis of an administrative primary care healthcare database

Background: Recent emergence of the dual bronchodilator LABA/LAMA class and new to market medications in the LAMA monotherapy and ICS/LABA fixed dose combination classes to treat COPD may drive new treatment pathways. Objectives: To identify initial treatment modifications of patients initiating a long-acting bronchodilator (LABD) or escalating to triple therapy (TT – LAMA/LABA/ICS) in France. Methods: Retrospective analysis of COPD patients in a primary care database (QuintilesIMS Longitudinal Patient Database). Cohort 1: new initiators of LABDs: LAMA, LABA, LAMA+LABA, LABA+ICS, and LABA+LAMA+ICS. Cohort 2: patients escalating to TT from a maintenance treatment regimen. Both cohorts were indexed on date of initiation/step-up (Jan 2008–Dec 2013) and were divided into mutually exclusive treatment modification subgroups based on the first change within the 18 months follow-up: continuous use (no modification), discontinuers, augmentors and switchers. Results: 4984 patients initiated a LABD, with LABA/ICS the most commonly initiated therapy in Cohort 1. 501 escalated to TT. Treatment modifications are reported below. Conclusions: Discontinuation among initiators of COPD maintenance therapy is high; few initiators switched to another class of COPD therapy or augmented their existing regimen. In patients stepping-up to TT, true discontinuation within 18 months is low. Funding: GSK (HO-15-16099)