A study published in the Chest revealed an increased incidence of cardiovascular major adverse events (MACEs) in patients started on single-inhaler triple therapy compared to those treated with an LABA-ICS inhaler in patients with chronic obstructive pulmonary disease (COPD).
The study aimed to determine the incidence of MACEs with single-inhaler triple therapy compared to LABA-ICS in the real-world clinical practice.
The researchers reviewed the data from the UK’s Clinical Practice Research Datalink and included the patients with COPD aged 40 years and above who were treated during 2017-2021. The researchers divided the LAMA-naive patients into two groups, i.e., initiators of single-inhaler triple therapy (SIT) and LABA-ICS users (LIU), in a 1:1 ratio. The patients were evaluated based on the incidence of MACEs (all-cause mortality or hospitalization because of stroke or myocardial infarction) for >1 year.
There were 10,255 patients in the SIT group and 10,255 in the LIU group. The incidence rate of MACEs was 11.3 per 100 per year in the SIT group and 8.8 per 100 per year in the LIU group. Patients in the SIT group had a 28% increased risk of developing MACEs than the patients in the LIU group; however, this increase was primarily in the initial four months (hazard ratio (HR): 1.41).
The HR for hospitalization due to stroke was 1.06, and due to myocardial infarction was 1.00 in the SIT group relative to the LIU group. The SIT group also has an all-cause mortality HR of 1.31.
