@article{Vogelmeier:2018:10.2147/COPD.S160011,
author = {Vogelmeier, CF and Chapman, KR and Miravitlles, M and Roche, N and Vestbo, J and Thach, C and Banerji, D and Fogel, R and Patalano, F and Olsson, P and Kostikas, K and Wedzicha, JA},
doi = {10.2147/COPD.S160011},
journal = {International Journal of Chronic Obstructive Pulmonary Disease},
pages = {1125--1134},
title = {Exacerbation heterogeneity in COPD: subgroup analyses from the FLAME study},
url = {http://dx.doi.org/10.2147/COPD.S160011},
volume = {13},
year = {2018}
}

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TY  - JOUR
AB  - Background: The FLAME study compared once-daily indacaterol/glycopyrronium (IND/GLY) 110/50 µg with twice-daily salmeterol/fluticasone (SFC) 50/500 µg in symptomatic patients with moderate to very severe COPD and a history of exacerbations in the previous year.Methods: This prespecified and post hoc subgroup analysis evaluated treatment efficacy on 1) moderate/severe exacerbations according to prior exacerbation history and treatment, and 2) types of exacerbations according to health care resource utilization (HCRU) during 1-year follow-up.Results: IND/GLY reduced the rate of moderate/severe exacerbations versus SFC in patients with a history of 1 exacerbation (rate ratio [RR]: 0.83, 95% CI: 0.75–0.93), ≥2 exacerbations (RR: 0.85, 95% CI: 0.70–1.03) and ≥2 exacerbations or ≥1 hospitalization in the previous year (RR: 0.86, 95% CI: 0.74–1.00). Prolonged time-to-first exacerbation was observed in all the groups according to exacerbation history. Moderate/severe exacerbations decreased with IND/GLY versus SFC, independent of previous treatment. IND/GLY significantly reduced rates of moderate/severe exacerbations treated with antibiotics (RR: 0.79, 95% CI: 0.67–0.93) and systemic corticosteroids and antibiotics (RR: 0.80, 95% CI: 0.70–0.91); rates of exacerbations treated with systemic corticosteroids alone were comparable (RR: 0.99, 95% CI: 0.80–1.22).Conclusion: Overall, IND/GLY demonstrated consistent beneficial effects versus SFC on moderate/severe exacerbations, independent of prior exacerbation history or treatment. The efficacy of IND/GLY on exacerbation prevention was superior to SFC for exacerbations treated with antibiotics with/without systemic corticosteroids and was similar for exacerbations treated with systemic corticosteroids alone.
AU  - Vogelmeier,CF
AU  - Chapman,KR
AU  - Miravitlles,M
AU  - Roche,N
AU  - Vestbo,J
AU  - Thach,C
AU  - Banerji,D
AU  - Fogel,R
AU  - Patalano,F
AU  - Olsson,P
AU  - Kostikas,K
AU  - Wedzicha,JA
DO  - 10.2147/COPD.S160011
EP  - 1134
PY  - 2018///
SN  - 1176-9106
SP  - 1125
TI  - Exacerbation heterogeneity in COPD: subgroup analyses from the FLAME study
T2  - International Journal of Chronic Obstructive Pulmonary Disease
UR  - http://dx.doi.org/10.2147/COPD.S160011
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000429594700002&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/60364
VL  - 13
ER  - 

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