Health status changes in COPD patients after real-life switch from tiotropium or salmeterol/fluticasone to indacaterol/glycopyrronium using the EQ-5D-3L instrument: results from the POWER study

Introduction: POWER evaluated the real-life effectiveness of indacaterol/glycopyrronium (IND/GLY) in the management of patients with COPD switched directly from tiotropium (TIO) or salmeterol/fluticasone propionate combination (SFC). Herein we discuss lung function primary endpoint and the impact of IND/GLY switch on health status with the EuroQol 5 Dimension 3 level (EQ-5D-3L) instrument. Methods: POWER, a single-arm, open-label, prospective, multicenter, interventional study enrolled patients with moderate-to-severe COPD symptomatic despite treatment with TIO 18 µg once-daily (qd) or any twice-daily SFC dose. Patients were switched (no washout) to IND/GLY 110/50 µg qd for 16 wks; outcomes included change from baseline in trough (t)FEV1 and EQ-5D-3L health status at wk 4 and 16 by population responses and patient trajectories (shift tables). Results: Patients switched from TIO and SFC had mean improvements from baseline in tFEV1 of 142 and 118 mL at wk 4, and of 176 and 172 mL at wk 16, respectively. The EQ-5D-3L showed improvements in health status for all dimensions over the study, regardless of former treatment. Trajectories of patients who reported health status impairment at baseline similarly showed improvements regardless of former treatment. IND/GLY switch was well tolerated, with no new safety signals emerging from the study. Conclusion: In clinical practice, IND/GLY direct switch provided clinically significant improvements in lung function and translated into improved health status as per the EQ-5D-3L tool regardless of former TIO or SFC in patients with moderate-to-severe COPD.