MISSISSAUGA, ON, June 17, 2013 /CNW/ - A second analysis of data from real-world study PATHOS, recently published in the British Medical Journal, shows that treatment of chronic obstructive pulmonary disease (COPD) patients with SYMBICORT® (budesonide/formoterol) was associated with a lower incidence of pneumonia and pneumonia related death, compared to treatment of COPD patients with ADVAIR® (fluticasone/salmeterol).i PATHOS is the largest real-world study to compare the effectiveness and safety of two commonly prescribed inhaled corticosteroid and long-acting beta agonist (ICS/LABA) combination treatments for COPD with more than one year of patient follow-up.i
Overall, the ADVAIR® treatment group was associated with a 73% higher pneumonia rate (rate ratio [RR] 1.73 [95% confidence interval [CI] 1.57-1.90]; p® group.i Similarly, the ADVAIR® treatment group was associated with 74% higher pneumonia-related hospital admissions than the SYMBICORT® treatment group (RR 1.74 [95% CI 1.56-1.94]; p® treatment group compared to 4.3 hospitalizations per 100 patient-years in the SYMBICORT® treatment group.i A corresponding 82% increase in hospital days (53 versus 29 days per 100 patient-years, respectively; p® treatment group.i
The average duration of pneumonia-related hospitalizations was similar for both groupsi but the ADVAIR® treatment group was associated with a higher risk of pneumonia-related death (97 deaths) compared to the SYMBICORT® treatment group (52 deaths) (hazard ratio [HR] 1.76; 95% CI 1.22-2.53; p=0.0025).i
"As a frequent complication of COPD, pneumonia is associated with considerable health cost and mortality" said Dr. Charlie Chan, Professor and Vice-Chair of Medicine, University of Toronto, consultant Respirologist, University Health Network. "This data is significant as it is the first to compare pneumonia rates between two commonly prescribed ICS/LABA combinations in the same matched COPD study population, and can help uncover gaps in care, providing additional information on the efficacy and safety of treatments as experienced in the real-world setting."
A previous analysis of PATHOS data regarding the risk of COPD related moderate and severe exacerbations and hospitalizations was published earlier this year in the Journal of Internal Medicine.ii Together, these analyses of real-world evidence provide insight into the impact of the two treatment combinations in clinical practice, providing healthcare providers, patients and payers with valuable information to further inform their treatment decisions.
The 11-year PATHOS study, led by Uppsala University, retrospectively examined the medical records of 5,468* ICS/LABA-treated patients in Sweden from 1999 to 2009; a total of 19,000 patient years.i This second published analysis of the data compares the rate of pneumonia associated with two commonly prescribed combinations.i To allow for a valid comparison, a cohort of patients treated with ADVAIR® were individually matched with an equal number of patients treated with SYMBICORT®, a second ICS/LABA.i Investigators used a statistical technique called "propensity score matching" to minimize bias and ensure the two ICS/LABA-treated groups were comparable in terms of variables including age, gender, and measures of disease severity such as medication use, COPD co-morbidities, previous hospitalizations for any cause and exacerbation rates for COPD, and other conditions like respiratory infections prior to the first ICS/LABA prescription.i
