New insights into the optimal management of COPD: extracts from CHEST 2021 annual meeting (October 17–20, 2021)

Figures & data

Figure 1. Mean number of exacerbations, time to first exacerbation and time to change in treatment in GOLD-compliant versus non-GOLD-compliant treatment regimens. (a) Mean number of any exacerbations per patient year; *P < 0.05; **P < 0.001; ***P < 0.0001 (negative binomial regression). (b) Mean time to first exacerbation among patients with ≥1 exacerbation; *P < 0.05; **P < 0.001; ***P < 0.0001 (t-test). (c) Mean time to first index therapy change; **P < 0.001; ***P < 0.0001 (t-test). (d) Mean time to discontinuation of index therapy; **P < 0.001; ***P < 0.0001 (t-test). GOLD, Global Initiative for Chronic Obstructive Lung Disease.

Figure 2. (a) Risk of first COPD exacerbation. (b) Risk of first hospitalization for community-acquired pneumonia.

HR, hazard ratio; ICS, inhaled corticosteroids; IR, incidence rate; LAMA, long-acting muscarinic antagonist; LABA, long-acting β2-agonist; LCL, lower confidence limit; T/O, tiotropium + olodaterol; UCL, upper confidence limit.HR, hazard ratio; ICS, inhaled corticosteroids; IR, incidence rate; LAMA, long-acting muscarinic antagonist; LABA, long-acting β2-agonist; LCL, lower confidence limit; T/O, tiotropium + olodaterol; UCL, upper confidence limit. GOLD, Global Initiative for Chronic Obstructive Lung Disease.

Figure 3. Kaplan-Meier analysis of time to COPD-related hospitalization among (a) treatment naïve MAPD patients and (b) MAPD patients with no exacerbation history. Measured from index date + 1, or discharge date + 1, if patient had inpatient visit crossing index date, until discontinuation of the index therapy. Diagnosis of interest must have occurred within an inpatient visit that began in the on-treatment period.

Figure 3. COPD, chronic obstructive pulmonary disease; MAPD, Medicare with Part D; PSM, propensity score matching; TIO+OLO, tiotropium/olodaterol; TT, triple therapy. Wald chi-square test using robust standard errors in a proportional hazard model was used for assessing equality of hazard rates.

Figure 4. Primary endpoint results.

Figure 4. COPD, chronic obstructive pulmonary disease; ET_80%, elapsed time over which a flow of >80% of peak flow was achieved; FAS, full analysis set; IR, inspiratory resistance; L, liters; PIF, peak inspiratory flow; s, seconds; SE, standard error; T_in, total inhalation time; T_PIF, time to PIF; VC_in, total inhaled volume; V_PIF, inhaled volume at PIF as a percentage of VC_in.

Table 1. Summary of findings

	Inhaler device IR Low → Medium → High	Maneuvers Maximal → Spontaneous
PIF (L/s)	↓	↓
Tin (s)	↑	↑
VCin (L)	↓	↓
TPIF (s)	↑	↑
ET80% (s)	↑	↑
VPIF (% VCin)	↓	=

↓ decrease, ↑ increase, = no change.

ET_80%, elapsed time over which a flow of >80% of peak flow was achieved; L, liters; PIF, peak inspiratory flow; s, seconds; T_in, total inhalation time; T_PIF, time to PIF; VC_in, total inhaled volume; V_PIF, inhaled volume at PIF as a percentage of VC_in.

Figure 5. Key findings from the survey

^#Bar charts represent the number of respondents answering the survey questions; *Electronic format included video and text on asmartphone.