Characteristics of new users of aclidinium, aclidinium/formoterol, and other COPD medications in three European countries

Background: Use of aclidinium bromide (AB) and aclidinium/formoterol (AB/FF) in the real world is not fully characterized in Europe. Aim: To describe characteristics of new users of AB, AB/FF, and other COPD medications in the United Kingdom (UK), Denmark, and Germany. Methods: Cohorts in the UK Clinical Practice Research Datalink GOLD (2015-2017), the Danish National Health Databases (2015-2017), and the German Pharmacoepidemiological Research Database (2015) included new users of long-acting muscarinic antagonists (LAMA) (AB, AB/FF, tiotropium, other LAMA), long-acting beta2-agonists (LABA), or LABA/inhaled corticosteroids (LABA/ICS). New users were characterized according to age, sex, lifestyle factors, comorbidity, COPD and asthma diagnoses, comedications, and COPD severity. Results: The study included 17,668 new users of AB and 14,808 new users of AB/FF. New users of LAMA medications were older (median range, 69-71 years) than users of LABA or LABA/ICS (median range, 53-67 years). Smoking was more frequent in LAMA users (20.1% to 39.9%) than in LABA or LABA/ICS users (7.9% to 26.8%). Hypertension, depressive disorders, urinary tract infections, and diabetes were frequent comorbidities. COPD diagnosis was more frequent in LAMA (46.8% to 92.8%) than in LABA or LABA/ICS (24.2% to 65.5%) users. In the UK, AB users had a higher proportion of severe COPD than AB/FF users; the opposite applied to the other countries. Conclusion: AB, AB/FF users showed similar characteristics to those of other LAMA users. Compared with LABA and LABA/ICS users, AB and AB/FF users were older, had a higher frequency of severe COPD, chronic comorbidities, and use of COPD comedications.