COPD rehospitalization outcomes similar with dry-powder vs soft-mist inhalers

The delivery of once-daily fixed-dose combination (FDC) dual bronchodilators for chronic obstructive pulmonary disease (COPD) does not appear to influence disease-related rehospitalization outcomes, according to a study.

Using the Japanese Diagnosis Procedure Combination database, the researchers identified 31,145 COPD patients who were at least 40 years of age and received prescription for optimal once-daily FDC dual bronchodilator delivered via a dry powder inhaler (DPI; n=18,359) or a soft mist inhaler (SMI; n=12,786). Those who received a prescription for inhaled corticosteroids were excluded.

Inverse probability of treatment weighting (IPTW) method was applied to compare outcomes including COPD-related rehospitalization, outpatient prescription of antibiotics and oral corticosteroids, and cardiovascular event-related rehospitalization between the DPI and SMI groups.

The incidence of COPD-related rehospitalization was similar between the DPI and SMI groups (25.4 percent vs 24.7 percent; p=0.379), as was the percentage of patients who received outpatient prescription of antibiotics and oral corticosteroids (7.8 percent vs 7.8 percent; p=0.819).

However, significantly fewer patients in the DPI group than in the SMI group had cardiovascular event-related rehospitalizations (4.3 percent vs 5.2 percent; p=0.004).

In subgroup analyses, COPD-related rehospitalizations occurred less frequently among patients with Hugh-Jones classification 4–5 in the SMI group than in the DPI group (–2.1 percent, 95 percent confidence interval, –4.0 percent to –0.3 percent).