TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH TRIPLE THERAPY WITH BUDESONIDE/GLYCOPYRRONIUM/FORMOTEROL: FROM RECOMMENDATIONS TO DAILY PRACTICE

Abstract

  ORESTES study aimed to describe the occurrence of exacerbations, clinical characteristics, and healthcare resource utilization in patients with chronic obstructive pulmonary disease (COPD) initiating budesonide/glycopyrrolate/formoterol fumarate (BGF) in a real-life setting. Observational, retrospective, multicenter study in patients with COPD aged ≥ 40 years starting BGF treatment at their physician’s discretion in routine clinical practice. Data were retrieved 12 months before and up to 12 months after BGF initiation. A total of 718 patients were evaluated, of whom 89.3 % completed 12 months of BGF treatment. At BGF initiation, most patients were classified as having high-risk phenotype (72.3 %), 78.4 % presented with dyspnea (Modified Medical Research Council, mMRC, grade ≥ 2), 50.9 % were Global Initiative for Obstructive Lung Disease (GOLD) E, 93.0 % had ≥ 3 comorbidities, and 79.7 % ≥ 1 cardiovascular comorbidity. Prior to initiation of BGF, 41.1 % had received dual therapy and 49.6 % triple therapy. After BGF initiation, the proportions of patients experiencing moderate and severe exacerbations decreased by 20.8 % and 23.1 %, respectively. Oral corticosteroids and antibiotics use decreased by 17.1 %, and 18.2 %, respectively. Results from the ORESTES clinical practice study showed that COPD treatment with triple therapy with BGF is effective, characterized by high adherence to treatment when prescribed to complex, high-risk COPD patients even after intensive prior therapy. It should be noted that even in this complex patient group, where nearly half of patients have already received maximum COPD treatment with triple therapy, a further reduction in exacerbation frequency and healthcare costs was observed after BGF administration. This not only emphasizes the clinical benefit for complex patients but also indicates that the earlier triple therapy with BGF is started, even before disease progression, the more strengthening the treatment can help optimize outcomes and prevent further for deterioration.