Assessment of Mortality and COPD Exacerbations in GOLD E COPD Patients in the Netherlands
Author(s)
Ernesto Mayen Herrera, BSc, MSc1, Ying Zheng, MHSA, MS2, Richard Hiraiwa STANFORD, MS, PharmD3, Kathryn Evans, MS, MPH4, Noami Berfeld, MSc5, Jordy Gaspersz, MSc6, Naomi Reimes, MSc6.
1Sanofi Inc., Morristown, NJ, USA, 2Sanofi, Cambridge, MA, USA, 3AESARA, Chapel Hill, NC, USA, 4Thermo Fisher Scientific, Waltham, MA, USA, 5Thermo Fisher Scientific, London, United Kingdom, 6PHARMO Institute for Drug Outcomes Research, Utrecht, Netherlands.
1Sanofi Inc., Morristown, NJ, USA, 2Sanofi, Cambridge, MA, USA, 3AESARA, Chapel Hill, NC, USA, 4Thermo Fisher Scientific, Waltham, MA, USA, 5Thermo Fisher Scientific, London, United Kingdom, 6PHARMO Institute for Drug Outcomes Research, Utrecht, Netherlands.
OBJECTIVES: To estimate the incidence of mortality in the overall COPD population and in those with Global Initiative for Chronic Obstructive Lung Disease Category E (GOLD-E) COPD within real-world settings in the Netherlands.
METHODS: In this longitudinal observational study, COPD patients (≥40 years) with primary care, outpatient pharmacy, hospital and ambulatory visits data were identified from the PHARMO Data Network (2017-2022; index event was defined as first FEV1 measurement at/after COPD diagnosis). Patients were required to have ≥1 COPD encounter and ≥12 months of continuous data during pre-index. GOLD-E patients were defined as those with ≥2 moderate exacerbations/≥1 COPD-related hospitalisation during ≥12 months pre-index. The cumulative incidence of mortality was estimated from index until end of follow-up using Kaplan-Meier analysis across three cohorts. Cohort 1: overall COPD patients; Cohort 2: GOLD-E patients who were former smokers on dual (ICS/LABA or LABA/LAMA) or triple (ICS/LABA/LAMA) therapy; and Cohort 3: GOLD-E patients with moderate-to-severe disease (GOLD 2/3).
RESULTS: The study identified 12,446 COPD patients (cohort 1), of which, 260 and 625 were included in cohort 2 and cohort 3, respectively. COPD patients in cohort 1 were elderly (median age, 69 years; 55% male), with 36.6% currently smoking and 39.3% having a cardiovascular co-morbidity. Patients in cohort 2 and 3 were slightly older (median age: 73 and 71 years, respectively), with a higher proportion having cardiovascular comorbidities (46.9% and 45.9%, respectively). The cumulative incidence of mortality at 5 years was 16.0% (95%CI: 15.2%-16.8%), 23.9% (95%CI: 17.6%-29.4%) and 23.5% (95%CI: 19.7%-27.8%) for cohort 1, 2 and 3, respectively.
CONCLUSIONS: Our findings indicate that COPD patients in the Netherlands had high cardiovascular comorbidity burden and mortality risk, particularly among those meeting GOLD-E. We further estimated mortality in approximately one-fourth of patients in 5 years in GOLD-E patients who were former smokers or had moderate-to-severe disease.
METHODS: In this longitudinal observational study, COPD patients (≥40 years) with primary care, outpatient pharmacy, hospital and ambulatory visits data were identified from the PHARMO Data Network (2017-2022; index event was defined as first FEV1 measurement at/after COPD diagnosis). Patients were required to have ≥1 COPD encounter and ≥12 months of continuous data during pre-index. GOLD-E patients were defined as those with ≥2 moderate exacerbations/≥1 COPD-related hospitalisation during ≥12 months pre-index. The cumulative incidence of mortality was estimated from index until end of follow-up using Kaplan-Meier analysis across three cohorts. Cohort 1: overall COPD patients; Cohort 2: GOLD-E patients who were former smokers on dual (ICS/LABA or LABA/LAMA) or triple (ICS/LABA/LAMA) therapy; and Cohort 3: GOLD-E patients with moderate-to-severe disease (GOLD 2/3).
RESULTS: The study identified 12,446 COPD patients (cohort 1), of which, 260 and 625 were included in cohort 2 and cohort 3, respectively. COPD patients in cohort 1 were elderly (median age, 69 years; 55% male), with 36.6% currently smoking and 39.3% having a cardiovascular co-morbidity. Patients in cohort 2 and 3 were slightly older (median age: 73 and 71 years, respectively), with a higher proportion having cardiovascular comorbidities (46.9% and 45.9%, respectively). The cumulative incidence of mortality at 5 years was 16.0% (95%CI: 15.2%-16.8%), 23.9% (95%CI: 17.6%-29.4%) and 23.5% (95%CI: 19.7%-27.8%) for cohort 1, 2 and 3, respectively.
CONCLUSIONS: Our findings indicate that COPD patients in the Netherlands had high cardiovascular comorbidity burden and mortality risk, particularly among those meeting GOLD-E. We further estimated mortality in approximately one-fourth of patients in 5 years in GOLD-E patients who were former smokers or had moderate-to-severe disease.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
P30
Topic
Clinical Outcomes, Epidemiology & Public Health, Study Approaches
Topic Subcategory
Clinical Outcomes Assessment
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)