Presented at the American Thoracic Society Annual Meeting, Virtual, May 14–19, 2021

Objectives

Jeronimo Espinosa1, Thiago Nogueira2, Claudia Soares2, Gabriela Abreu2, Felipe Moraes dos Santos3, Juan Criniti1, Alejandro Raimondi1, Rosana Felice1,

Valeria Beruto4, Paula Scibona4, Waldo Belloso4, Nadia Savoy4, Gabriela Alejandra Blugerman5, Graciela Svetliza6, Esteban Wainstein6, Hernán Talamoni7, Néstor Pisapia7

ResultsRationale

Characteristics of COPD patients before first controller therapy from Hospital Italiano, Argentina

1GlaxoSmithKline, Buenos Aires, Argentina; 2GlaxoSmithKline, Rio de Janeiro, RJ, Brazil; 3GlaxoSmithKline, Santiago, Chile; 4Clinical Pharmacology Section, Hospital Italiano de Buenos Aires, Argentina; 5Research Department, Hospital Italiano de Buenos Aires, Argentina; 6Adult Pulmonology Section, Hospital Italiano de Buenos Aires, Argentina; 7Pediatric Pulmonology Section, Hospital Italiano de Buenos Aires, Argentina

• Describe the characteristics of COPD patients undergoing first COPD controller

therapy

• Evaluate the first COPD controller treatment used in a health maintenance

organization (HMO) in Buenos Aires, Argentina.

Disclosures

• This study was funded by GlaxoSmithKline (GSK study PRJ2763).

• CS, JC, JE, RF and AR are GlaxoSmithKline employees and hold stocks; FM is a GlaxoSmithKline employee; GA and TN are complementary workers at GlaxoSmithKline; VB, PS, NS, GAB, GS, EW, WB, HT, NP are employees of

Hospital Italiano de Buenos Aires, Buenos Aires; Hospital Italiano de Buenos Aires received funding from GlaxoSmithKline to conduct the study.

• On behalf of all authors, an audio recording of this poster was prepared Jeronimo Espinosa, who did not receive any payment for this recording.

Some chronic obstructive pulmonary disease (COPD) patients are not adequately controlled

and are at risk of future exacerbations that could significantly deteriorate patient health.

Identifying COPD patients most at risk is key to implementing an earlier and optimized

treatment approach.

AcknowledgementsEditorial support (in the form of writing assistance, including preparation of the draft poster under the direction and guidance of the authors, collating and incorporating authors’ comments for each draft, assembling tables and figures, grammatical editingand referencing) was provided by Tony Reardon, at Aura (a division of Spirit Medical Communications Ltd), and was funded by GSK.

Scan the QR code or go

to https://tago.ca/-ATS14 to access a

downloadable version of this

presentation

Methods

Electronic medical

records

Pharmacy

dispensing data

Retrospective

cohort study

Data sources Study design Study population

COPD patients

Aged ≥35 years

Study dates

01 Jan 2007–

31 Dec 2018

Timeframe

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

2 complete years follow-up

Incomplete follow-up period

Baseline period (1 year before index date)

Index date: 1st dispensed

controller

End of patient

follow-up

Lost to

follow-up

First COPD health

problem registered

Index date

Date first controller dispensed (inhaled

corticosteroid [ICS], long-acting β2 agonist

[LABA], or long-acting muscarinic antagonist

[LAMA], and combinations)

Study

start

Study

end

Baseline: 1 year before index date

Follow-up: 2 years after index date

Conclusions

n=2424

COPD patients

49.5%

n=119950.5%

n=1225 Mean age:

72.5 years (standard deviation 9.9)

Nutritional status

Most common comorbidities before or at index date

Depression

n=536

22.1%

Asthma

n=452

18.7%

Hypertension

n=1586

65.4%

Myocardial

infarctionn=339

14.0%

No moderate or

severe exacerbation

(69.6%)

1 (21.7%)2 (4.9%)3 (1.9%)≥4 (2.0%)

Number of moderate or severe exacerbations* (% patients)

87.1

8.5

2.5

0.7

1.2

0 20 40 60 80 100

0

1

2

3

≥4

exacerb

ati

on

s

Proportion of patients with moderate exacerbations

Proportion of patients with severe exacerbations

% patients

79.0

17.7

2.5

0.7

0.1

0 20 40 60 80 100

0

1

2

3

≥4

exacerb

ati

on

s

% patients

12.9%of patients had

≥1 moderate

exacerbation

at baseline

21.0%of patients had

≥1 severe

exacerbation

at baseline

Figure 1. Proportion of patients with exacerbations at baseline (i.e. the 12 months prior to index date)

30.5%of patients had ≥1

exacerbation at baseline

No moderate or

severe exacerbation

(69.5%)

10.96.6

3.5 4.40.6 1.2

9.9 10.66.3

13.1

21.026.9

80.474.7

60.454.6

0.0 0.2 0.2 0.30.0 0.0 0.8 0.51.84.2 4.2 2.7

0

10

20

30

40

50

60

70

80

90

100

2007 - 2009 2010 - 2012 2013 - 2015 2016 - 2018

% p

atie

nts

Triennium

ICS

LABA

LAMA

ICS+LABA

ICS+LAMA

LABA+LAMA

ICS+LABA+LAMA

COPD, chronic obstructive pulmonary disease; ICS, inhaled corticosteroid; LABA, long-acting β2 agonist; LAMA, long-acting muscarinic antagonist.

Use of LABA over time

Use of LAMA over timeUse of ICS+LABA over time

Figure 2. Frequency of first controller use per trienniums 2007–2009, 2010–2012, 2013–15, 2016–2018 in COPD patients from

Hospital Italiano, Argentina

ICS6.9%

LABA4.9%

LAMA15.1%

ICS+LABA, 69.6%

ICS+LAMA, 0.1%

LABA+LAMA, 0.3%

ICS+LABA+LAMA

0 10 20 30 40 50 60 70 80 90 100

Triple therapy

Dual therapy

Mono-therapy

% patients

Fir

st

co

ntr

oll

er

26.9%

(n=650)

70.0%

(n=1,698)

3.1%

(n=76)

ICS, inhaled corticosteroid; LABA, long-acting β2 agonist; LAMA, long-acting muscarinic antagonist.

Dual and triple therapy can be both single and multiple inhalers

Figure 3. Therapeutic class combination of the first controller use

Median time from diagnosis until first controller use: 6 months

The decrease of ICS+LABA as a first controller of COPD patients’ treatment through the

trienniums was linked to the launch of new controllers such as new LAMAs, used as

monotherapy or in combination with other drugs prescribed for COPD.

Almost one third of COPD patients in this HMO experienced exacerbations, and were at high risk

of future exacerbations, highlighting an addressable unmet need for treatment optimization.

37.4% (n=869)

Overweight(BMI 25.0-29.9 kg/m2)

29.6% (n=689)

Obese (BMI ≥30 kg/m2)

*Moderate, requiring systemic corticoid/antibiotic use;Severe, requiring Emergency Room visit/hospitalization

This study was funded by GlaxoSmithKline (GSK study PRJ2763).

On behalf of all authors, and with their permission, this poster is presented by Jeronimo Espinosa,

who did not receive any payment for this recording.

The authors declare the following real or perceived conflicts of interest in relation to this presentation:

‒ CS, JC, JE, RF and AR are GlaxoSmithKline employees and hold stocks; FM is a

GlaxoSmithKline employee; GA and TN are complementary workers at GlaxoSmithKline

‒ VB, PS, NS, GAB, GS, EW, WB, HT, NP are employees of Hospital Italiano de Buenos Aires,

Buenos Aires; Hospital Italiano de Buenos Aires received funding from GlaxoSmithKline to

conduct the study.

Editorial support (in the form of writing assistance, including preparation of the draft poster under the

direction and guidance of the authors, collating and incorporating authors’ comments for each draft,

assembling tables and figures, grammatical editing and referencing) was provided by Tony Reardon,

at Aura (a division of Spirit Medical Communications Ltd), and was funded by GSK.

DISCLOSURES

Scan the QR code or go

to https://tago.ca/-ATS14 to access

a downloadable version of this

presentation

Espinosa J, et al. Characteristics of COPD patients before first controller therapy from Hospital Italiano, ArgentinaAmerican Thoracic Society Annual

Meeting 2021

May 14–19, 2021