OBJECTIVES: Inhaled triple therapies (TTs), combining LABA, LAMA and ICS, are used as background treatment for COPD. Single inhaler TTs have been available since 2018. The study’s primary objective was to describe COPD patients initiating TT with single (SITT) or multiple (MITT) inhalers, according to the specialty of the prescribing physician – pulmonologist (PN) or general practitioner (GP). The secondary objective was to compare persistence (no treatment interruption >30 days) between SITT and MITT.

METHODS: Retrospective observational study using the real-world ambulatory medicalized database THIN® France, which is GDPR compliant, and incorporates claims data.

RESULTS: A total of 3,134 patients were included: mean age of 67±12 years, 56% men, and mean BMI of 28±7 kg/m². Main comorbidities were hypertension (44.4%), sleep disorders (36.8%), mood disorders (27.2%), anxiety disorders (26.8%) and depression (24.5%); 24.0% had associated asthma in the last 12 months. TT was initiated for 36.4% by a PN and for 51.1% by a GP. Prior to initiating TT, 84.1% of patients were on dual therapy, 7.8% on monotherapy and 8.1% were not treated. SITT was initiated in 485 patients (15.5%). Before TT initiation, 55.2% of patients had ≥ 1 severe and/or ≥ 2 moderate exacerbations, with no significant difference between PN and GP (OR: 0.94; CI95% [0.81 - 1.10]). At 1 year, only 11.3% of patients were persistent. The median persistence was 4.5 months with MITT and 6 months with SITT. The main predictor for persistence was the prescription of SITT rather than MITT, (HR:1.47; CI95% [1.27 - 1.69]).

CONCLUSIONS: This study shows that modalities of initiation of triple therapies are equivalent between GPs and PNs and that there is an improvement in persistence under SITT compared to MITT.