Patient Characteristics and Treatment Comparison Among Patients With Chronic Obstructive Pulmonary Disease: Real-World Evidence From Sweden
Author(s)
Eleni Kopsida, PhD1, Barbara Fuchs, PhD2, Emil Bojsen-Møller, PhD2, Sarah Friberg, MSc2, Marta Natalia Stelmaszuk, MSc3, Xinyu Yang, MPH4, Sun Sun, PhD3, John Junior Were, Msc4, Lowie Vanfleteren, PhD5.
1Value and Access Lead, Chiesi Pharma AB, Stockholm, Sweden, 2Chiesi Pharma AB, Stockholm, Sweden, 3Parexel International, Stockholm, Sweden, 4Parexel International, London, United Kingdom, 5University of Gothenburg, Gothenburg, Sweden.
1Value and Access Lead, Chiesi Pharma AB, Stockholm, Sweden, 2Chiesi Pharma AB, Stockholm, Sweden, 3Parexel International, Stockholm, Sweden, 4Parexel International, London, United Kingdom, 5University of Gothenburg, Gothenburg, Sweden.
OBJECTIVES: To investigate patient characteristics, treatment patterns, and healthcare resource utilization (HCRU) among patients with chronic obstructive pulmonary disease (COPD) in Sweden, and to explore potential differences in these parameters between those treated with extra-fine versus those with non-extra fine formulations of inhaled corticosteroid (ICS), for double (ICS/long-acting beta-agonist (LABA)) and triple (ICS/LABA/long-acting muscarinic antagonist (LAMA)) therapies, respectively.
METHODS: The study has linked several Swedish national registers together, including the Airway Register (SNAR), Patient Register, Cancer Register, Prescribed Drug Register, Cause of Death Register and Total Population Register. All COPD patients registered in the SNAR since 2017 and aged 40+ were included. An active comparator, new user (ACNU) design was employed to compare extra-fine and non-extra-fine formulations of inhaled ICS/LABA or ICS/LABA/LAMA therapies. The ACNU design is often used to conceptually emulate the design of a randomized controlled trial in pharmacoepidemiologic studies. Patient characteristics included socio-demographic (age, sex, education, employment, income, region, marital status) and clinical characteristics (comorbidities, smoking, body-massive index). HCRU encompasses primary care, outpatient, inpatient visits, drug dispensations, and COPD maintenance treatment/equipment utilization. Propensity score matching (PSM) will be applied to adjust patient characteristics between comparison arms, aiming to mimic a randomized controlled trial design. PSM will be performed for ICS/LABA and ICS/LABA/LAMA, respectively.
RESULTS: In this large COPD cohort (N=117,841, 55% male, mean age 71 years, 60% smoker), 2,651 patients initiated extra-fine and 11,773 non-extra-fine treatments. Extra-fine group had higher triple therapy use (81.37% vs 52.76%). ICS and ICS/LABA dispensations decreased slightly over time, while ICS/LABA/LAMA has increased, especially for extra-fine formulations. All analysis will be finalized July-September.
CONCLUSIONS: Patients in the extra-fine group had a higher use of triple therapy. Analysis on HCRU is ongoing and results will be updated in September 2025.
METHODS: The study has linked several Swedish national registers together, including the Airway Register (SNAR), Patient Register, Cancer Register, Prescribed Drug Register, Cause of Death Register and Total Population Register. All COPD patients registered in the SNAR since 2017 and aged 40+ were included. An active comparator, new user (ACNU) design was employed to compare extra-fine and non-extra-fine formulations of inhaled ICS/LABA or ICS/LABA/LAMA therapies. The ACNU design is often used to conceptually emulate the design of a randomized controlled trial in pharmacoepidemiologic studies. Patient characteristics included socio-demographic (age, sex, education, employment, income, region, marital status) and clinical characteristics (comorbidities, smoking, body-massive index). HCRU encompasses primary care, outpatient, inpatient visits, drug dispensations, and COPD maintenance treatment/equipment utilization. Propensity score matching (PSM) will be applied to adjust patient characteristics between comparison arms, aiming to mimic a randomized controlled trial design. PSM will be performed for ICS/LABA and ICS/LABA/LAMA, respectively.
RESULTS: In this large COPD cohort (N=117,841, 55% male, mean age 71 years, 60% smoker), 2,651 patients initiated extra-fine and 11,773 non-extra-fine treatments. Extra-fine group had higher triple therapy use (81.37% vs 52.76%). ICS and ICS/LABA dispensations decreased slightly over time, while ICS/LABA/LAMA has increased, especially for extra-fine formulations. All analysis will be finalized July-September.
CONCLUSIONS: Patients in the extra-fine group had a higher use of triple therapy. Analysis on HCRU is ongoing and results will be updated in September 2025.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
SA74
Topic
Clinical Outcomes, Economic Evaluation, Study Approaches
Topic Subcategory
Registries
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)