Budesonide-glycopyrrolate-formoterol does not improve clinical outcomes compared with fluticasone-umeclidinium-vilanterol<\/p>\n<\/h3>\n
By Elana Gotkine HealthDay Reporter<\/b>
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FRIDAY, Jan. 3, 2025 (HealthDay News) — For patients with chronic obstructive pulmonary disease (COPD), budesonide-glycopyrrolate-formoterol does not improve clinical outcomes compared with fluticasone-umeclidinium-vilanterol, according to a study published online Dec. 30 in The BMJ<\/em>.<\/p>\n William B. Feldman, M.D., M.P.H., from Brigham and Women’s Hospital in Boston, and colleagues compared the effectiveness and safety of budesonide-glycopyrrolate-formoterol, a twice-daily metered dose inhaler, and fluticasone-umeclidinium-vilanterol, a once-daily dry powder inhaler for treatment of COPD in routine clinical practice in a new-user, 1:1 propensity score-matched cohort study. The study included 20,388 propensity score-matched pairs of new users.<\/p>\n The researchers found that the incidence of a first moderate or severe COPD exacerbation was higher in patients who received budesonide-glycopyrrolate-formoterol (hazard ratio, 1.09; 95 percent confidence interval, 1.04 to 1.14; number needed to harm, 38) compared with those who received fluticasone-umeclidinium-vilanterol, while the incidence of first admission to hospital with pneumonia was identical between the groups (hazard ratio, 1.00; 95 percent confidence interval, 0.19 to 1.10). Those receiving budesonide-glycopyrrolate-formoterol compared with fluticasone-umeclidinium-vilanterol had a higher risk for a first moderate COPD exacerbation (hazard ratio, 1.07; 95 percent confidence interval, 1.02 to 1.12 ; number needed to harm, 54) and for a first severe COPD exacerbation (hazard ratio, 1.29; 95 percent confidence interval, 1.12 to 1.48; number needed to harm, 97). Similar findings were seen in prespecified sensitivity analyses.<\/p>\n “Our study may provide reassurance to health systems seeking to decrease greenhouse gas emissions by reducing use of metered dose inhalers, because the single-inhaler triple therapy with the lower carbon footprint (the dry powder inhaler, fluticasone-umeclidinium-vilanterol) was also associated with slightly improved clinical outcomes,” the authors write.<\/p>\n Several authors disclosed ties to the pharmaceutical and health information technology industries.<\/p>\n Abstract\/Full Text<\/a><\/p>\n Editorial (subscription or payment may be required)<\/a><\/p>\n