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Abstract: Poster Presentations |

RISK OF HOSPITALIZATION/EMERGENCY VISIT IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE BY INITIAL MEDICATION REGIMEN FREE TO VIEW

Rohit D. Borker, PhD*; Cortney Hayflinger, MS; Richard Stanford, MS
Author and Funding Information

GlaxoSmithKline, Research Triangle Park, NC


Chest


Chest. 2005;128(4_MeetingAbstracts):257S. doi:10.1378/chest.128.4_MeetingAbstracts.257S-b
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Abstract

PURPOSE:  To compare risk of all-cause & COPD-related emergency department (ED) visit/hospitalization in patients with COPD receiving initial maintenance therapy.

METHODS:  Retrospective observational analysis was conducted using data from a large managed care database ( > 30 managed care plans). Patients ≥ 40 years with a primary diagnosis of COPD within 1 year prior to initial treatment and at least 18 months of continuous eligibility were identified. Following cohorts were identified: ipratropium (IP), salmeterol (SL), inhaled corticosteroid (ICS), ICS plus SL in the same inhaler (FS), and IPR and albuterol (AL) in the same inhaler (IP/AL). Logistic regression analysis was performed that determined risk of all cause and COPD-related hosp/emergency room (ER) visit. The model adjusted for baseline differences in age, comorbities, COPD sub type, baseline oral corticosteroid, theophylline and albuterol use.

RESULTS:  In all, 14,368 patients were identified, 2122 IP, 1099 SL, 3940 ICS, 3819 FS and 3388 IP/AL. Compared with IP, FS reduced the risk of all-cause ER/hosp by 46 % (OR 0.539, CI: 0.467 to 0.622). In addition, ICS and SL reduced the risk by 41 %, (OR 0.594, CI: 0.516 to 0.683) and 36% (OR 0.640, CI: 0.529 to 0.774), respectively. IP/AL cohort was associated with a 12% risk reduction (OR 0.877, CI: 0.770 to 0.999). FS was also associated with a 69% lower risk (OR 0.309, CI: 0.200 to 0.475) of having a COPD related ER/hosp, while ICS and SL had 58%, (OR 0.419, CI: 0.287 to 0.611) and 61% (OR 0.387, CI: 0.216 to 0.694) lower risk, respectively. A 13% risk reduction, which was not statistically significant, was also observed in the IP/AL cohort (OR 0.868, CI: 0.645 to 1.167).

CONCLUSION:  Treatment of COPD with SL or ICS containing medications, especially when ICS and SL are used in combination (FS), may significantly decrease the risk of all-cause and COPD related ED/hosp compared to treatment with IP alone.

CLINICAL IMPLICATIONS:  These findings provide further evidence of clinical benefits for FSC in patients with COPD.

DISCLOSURE:  Rohit Borker, Employee GlaxoSmithKline

Wednesday, November 2, 2005

12:30 PM - 2:00 PM


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