Implementation of 2023 CTS guidelines for SITT could reduce exacerbation and mortality rates in COPD: PROMETHEUS Canada.

<bold>Background:</bold> COPD is the 4th leading cause of death in Canada. The ETHOS (<ext-link>NCT02465567</ext-link>) and IMPACT RCTs (<ext-link>NCT02164513</ext-link>) demonstrated reduced exacerbations and all-cause mortality for COPD patients on single-inhaler triple therapy (SITT). The 2023 Canadian Thoracic Society (CTS) guidelines recommend triple therapy and preferably SITT use in patients with moderate/severe symptom burden and high future risk of exacerbations. The clinical impact of broader SITT use in Canada has not yet been studied. <bold>Aim:</bold> To estimate the impact of higher SITT use based on CTS guidelines on mortality, exacerbations and their corresponding costs in Canada. <bold>Methods:</bold> A stochastic model using literature-derived characteristics (i.e. incidence, changes in COPD severity, treatment, mortality, and exacerbations) simulated the Canadian COPD population. Patients were assigned % of FEV1 predicted levels and their annual characteristics were modeled for 2024-2033 under 2 scenarios: “status quo” (current practice) and “increased SITT” (consistent with guidelines). <bold>Results:</bold> Based on our simulated results, higher SITT use over 10 years compared to current treatment reduced severe and moderate exacerbations by 13% and 18%, respectively, and reduced all-cause mortality by 22% (Fig 1). <bold>Conclusion:</bold> Appropriate use of SITT informed by CTS guidelines could lower mortality, exacerbations and their corresponding costs in COPD patients. <fig><object-id>erj;64/suppl_68/PA1170/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>