Trends in initial pharmacological treatment of COPD in Dutch primary care: a real-world analysis

Real-world data on initial inhaled therapy trends for chronic obstructive pulmonary disease (COPD) in Dutch primary care is scarce. Individuals aged ≥40 with COPD were included, using general practitioner data from PHARMO Database Network (2010-2021). Annual proportions of maintenance and reliever therapies within three months post-diagnosis, adjusted for age and sex, were calculated with the initial therapy recorded at the first prescription post-index date. Trends were analysed with joinpoint regression. Results are shown as annual percentage change (APC%, [95%CI]). 54,209 COPD patients (54% men, 65±11 years) were included. 36% had no prescriptions; 4% received other combinations. SABA peaked in 2018 (7.5 [6.4, 9.0]) and then plateaued. SABA/SAMA and SAMA showed no significant changes. LABA steadily increased throughout the period (4.0 [0.4, 7.1]). LAMA remained stable until 2015, after which it began to decline (−4.8 [−11.0, -2.8]). LABA/LAMA growth peaked at 47.7% (CI: 39.4-64.1) until 2016, then slowed to 12.0% (CI: 3.0-18.6) from 2016-2021. LABA/ICS decreased until 2016 (LABA/ICS -8.6 [−11.8, -7.3]) and then stabilized, while triple therapy remained constant (Fig. 1). Prescribing trends have changed over the past decade, possibly in response to national and international guidelines and the introduction of single-inhaler therapies. The study was supported by AstraZeneca, TEVA, Chiesi, and Boehringer Ingelheim. <fig><object-id>erj;64/suppl_68/PA1302/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>