OBJECTIVES: ICS/LABA fixed combinations are used in patients with COPD with a history of repeated exacerbations i.e. worsening of disease including infections and who have significant symptoms despite regular bronchodilator therapy. This study describes the characteristics of COPD patients initiating ICS/LABA in English primary care. METHODS: Patients with first prescription (index date) of fluticasone/salmeterol (FP/SM) or budesonide/formoterol (BUD/FM) between 01.01.2005-31.10.2011 and a prior COPD record were selected from CPRD primary care records linked to Hospital Episode Statistics. Baseline characteristics prior to first ICS/LABA prescription were described as proportions, means and rates (95%CI). Prior exacerbations were defined as: antibiotic or oral corticosteroid prescriptions or COPD hospitalisation; multiple events within 14 days were treated as one event. RESULTS: 26,875 patients age≥40 at index were included with 75.9% initiating FP/SM and 24.1% BUD/FM; mean age 70.3(70.1-70.4) and 69.0(68.8-69.3) years, respectively. In both cohorts 54% were male, approximately 36% current smokers, and 56% past smokers. Pneumonia within 1-year prior to index was slightly higher in FP/SM patients (1.9%(1.9-1.9)) compared to 1.4%(1.4-1.4) in BUD/FM), as was prior mean annual COPD hospitalisation rate (0.17(95%CI:0.16-0.17); 0.11(95%CI:0.10-0.12)). Amongst FP/SM patients 12.7%(95%CI:12.6-12.9) had COPD hospitalisations 1-year prior with 9.2%(95%CI:8.9-9.4) amongst BUD/FM. 37.2%(95%CI:36.7-37.7) of FP/SM patients received tiotropium 1-year prior with 35.4%(95%CI:34.5-36.2) amongst BUD/FM. The majority of patients had received short-acting ß2-agonist; FP/SM patients: 89.8%(95%CI:88.6-91.1), BUD/FM patients: 84.8%(95%CI :82.7-86.8). Proportions receiving inhaled-corticosteroids within 1-year prior was 50.9%(95%CI:50.3-51.6) and 48.0(95%CI:46.8-49.2) for FP/SM and BUD/FM, respectively, oral-steroids figures were 42.2%(95%CI:41.7-42.8) and 39.8%(95%CI:38.8-40.8), respectively, and mean annual exacerbation rate was 2.15(95%CI :2.12-2.18) and 2.02(95%CI:1.96-2.07), respectively, with 75.3%(95%CI:74.2-76.3) and 73.9%(95%CI:72.1-75.7), respectively, having exacerbations. CONCLUSIONS: Both groups had similar burden of COPD disease prior to starting fixed combination. The crude prevalences for some baseline characteristics were slightly higher in FP/SM vs. BUD/FM highlighting the need for rigorous propensity score matching in any comparative outcomes research.