Characteristics of COPD patients initiating treatment with aclidinium or tiotropium in primary care in Catalonia: a population-based study

Figures & data

Figure 1 Selection of the samples of patients included in the study.

Table 1 Baseline characteristics of COPD patients newly initiated on aclidinium or tiotropium in 2013

Patient variable	Extended COPD population		Restrictive population
	Aclidinium n=4,293	Tiotropium n=4,570	Aclidinium n=1,808	Tiotropium n=2,013
Sociodemographic characteristics
Sex (male), %	71.8	71.5	81.2	80.3
Age (years), mean (SD)	70.3 (10.9)	68.5 (11.6)***	69.8 (10.1)	67.3 (10.9)***
Tobacco consumption, %		***		***
Nonsmoker	32.0	24.9	15.04	10.2
Current smoker	22.0	32.4	29.3	41.6
Ex-smoker	43.4	39.9	53.5	44.8
Unknown	1.4	2.6	1.9	3.1
BMI (categorical), %
Underweight (BMI <18.5)	1.4	1.7	1.4	1.9
Normal weight (18.5≤ BMI <25)	19.8	20.3	21.7	22.1
Overweight (25≤ BMI <30)	38.6	37.6	39.4	38.8
Obese (BMI ≥30)	40.2	40.5	37.5	37.2
Respiratory comorbidities, %
At least one respiratory comorbidity	31.4	26.6***	24.3	17***
Asthma	16.3	12.6***	8	4.8***
Bronchiectasis	8.1	5.2***	7.6	3.3***
Sleep apnea	5.4	5.1	5.9	4.7
Other comorbidities, %
Hypertension	59	55.7**	58.7	53***
Diabetes	25.5	23.4*	25	22.6*
Metabolic syndrome	22.4	20.3*	22	19.3*
Anxiety or depression	15.6	14.6	14.4	12.2*
Time from COPD diagnosis (years), median (interquartile range)	5 (1–9)	1 (0–6)***	3 (0–6)	0 (0–3)**
Spirometry, n (%) in the previous year	812 (18.9)	1,113 (24.3)***	518 (28.6)	651 (37.3)***
FEV1 (% predicted), mean (SD)	60.5 (20.4)	63.2 (20.0)**	57.6 (18.1)	60.5 (18.9)**
At least one exacerbation in the previous year, %	62.1	52.4***	67.5	54.2***
Use of vaccines, %
Influenza	70.0	56.1***	80.5	64.9***
Pneumococcus	80.2	67.6***	69.7	53.2***

Notes: Data are expressed as n (%), unless otherwise indicated. Body mass index had missing values.

* P<0.05,

** P<0.01,

*** P<0.001.

Abbreviations: BMI, body mass index; COPD, chronic obstructive pulmonary disease; FEV₁, forced expiratory volume in 1 second; SD, standard deviation.

Table 2 Baseline respiratory treatment of COPD patients newly initiated on aclidinium or tiotropium in 2013

Patient variable	Extended COPD population		Restrictive population
	Aclidinium n=4,293	Tiotropium n=4,570	Aclidinium n=1,808	Tiotropium n=2,013
Without current treatment, %	41.3	62.3a	43.4	68.6a
SABA	29.7	18.7a	28.8	15.6a
SAMA	9.5	5.3a	10	4.1a
LABA	42.8	23a	41.9	18.8a
LAMA	4.1	0a	4.9	0a
ICS	43.0	23.4a	40.0	17.4a
Treatment regimen, %*
LABA + ICSa	32.8	18.6a	29.3	13.6a
LABA + LAMA + ICS	2.4	0a	1.4	0a

Notes: Data are expressed in %.

a P<0.05.

* LABA + ICS can also include SABA and SAMA.

Abbreviations: COPD, chronic obstructive pulmonary disease; ICS, inhaled corticosteroid; LABA, long-acting β₂ agonist; LAMA, long-acting antimuscarinic agent; SABA, short-acting β₂ agonist; SAMA, short-acting antimuscarinic agent.

Table 3 Independent factors associated with newly initiated aclidinium instead of tiotropium in 2013

Variable	Extended COPD population			Restrictive population
	Estimated adjusted OR	95% confidence interval	P-value	Estimated adjusted OR	95% confidence interval	P-value
Age	0.99	0.99–1.00	0.74	1.00	0.99–1.01	0.14
Sex (reference: male)
Female	0.88	0.79–0.97	0.02	0.98	0.82–1.17	0.85
Time from COPD diagnosis	1.04	1.03–1.05	<0.001	1.09	1.07–1.11	<0.001
Tobacco consumption (reference: nonsmoker)
Current smoker	0.73	0.64–0.84	<0.001	0.66	0.52–0.84	0.001
Ex-smoker	0.94	0.83–1.05	0.31	0.81	0.65–1.01	0.07
Unknown	0.53	0.38–0.74	<0.001	0.65	0.40–1.05	0.08
Concomitant COPD treatment (reference: 0)	1.40	1.34–1.45	<0.001	1.48	1.39–1.57	<0.001
Visit to primary care physician (reference: 0)	1.01	1.00–1.01	0.001	1.02	1.01–1.03	<0.001
Exacerbations in the previous year (reference: 0)	1.10	1.05–1.15	<0.001
Spirometry (reference: no)	0.79	0.71–0.88	<0.001	0.70	0.61–0.81	<0.001

Note: Adjusted models only for significant variables.

Abbreviation: OR, odds ratio.

Figure 2 Treatment persistence at 3, 6, and 9 months for aclidinium and tiotropium in the overall population.

Table 4 Compliance with LAMA prescribed at study initiation

Persistence	Extended COPD population		Restrictive population
	Aclidinium n=4,293	Tiotropium n=4,570	Aclidinium n=1,808	Tiotropium n=2,013
MPR, mean (SD)	0.71 (36.2)	0.77 (33.9)	0.73 (34.9)	0.78 (32.9)
MPR, %
<80	49.0	41.8	48.9	42.9
80–120	46.4	54.0	46.7	53.4
>120	4.6	4.2	4.4	3.8

Note: Data are expressed in (%), unless otherwise indicated.

Abbreviations: LAMA, long-acting antimuscarinic agent; MPR, medication possession ratio; SD, standard deviation.