Abstract Rationale To describe real-world treatment pattern in patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) requiring hospitalization and to estimate 30-day readmission rates in an adult population within the United States. Methods A retrospective cohort analysis was conducted using Optum® Market Clarity data including patients ≥40 years old who received inhaled maintenance treatment of long-acting muscarinic antagonist (LAMA) and/or long-acting β2-agonist (LABA), with or without inhaled corticosteroids (ICS), and were hospitalized with an AECOPD between January 1, 2022, and December 31, 2024. The first observed AECOPD hospitalization was the index event; date of discharge was the index date. Baseline demographic, clinical characteristics, and maintenance therapy use were assessed in the 12 months prior to the index event using descriptive statistics. Patients were followed up to 30 days from the index date to assess the outcome of readmission; analyses were performed on the overall patient sample and stratified by blood eosinophil count (BEC) status. Results Population characteristics are shown in the table and include patients hospitalized for AECOPD who received long-acting bronchodilators (LA-BD: LAMA and/or LABA) pre-index (N = 64,862). Treatment pattern in patients on ICS prehospitalization (82%; 53,362/64,862), inclusive of 50% (32,681/64,862) on LABA/LAMA dual therapy plus ICS ie, triple-therapy), showed that 88% of these patients maintained an outpatient prescription for ICS within 30 days postdischarge. For 18% (11,500/64,862) of patients not on ICS prehospitalization, only 23% (1,127/4,969) on prior LAMA or LABA monotherapy and 15% (966/7,531) on prior LABA/LAMA dual therapy initiated a new ICS within 30 days postdischarge. During the pre-index period, 39% (25,458/64,862) of patients had a BEC available. In contrast to GOLD guidelines recommendations, BEC distributions were similar between patients prescribed ICS versus those not prescribed ICS. Among patients on LA-BD plus ICS prehospitalization who continued ICS posthospitalization (n = 46,714), 18% (3,226/17,706) on LABA or LAMA monotherapy plus ICS and 17% (5,040/29,008) on LABA/LAMA/ICS triple therapy had a readmission within 30 days of discharge. Among patients on LA-BD who added ICS postdischarge, 16% (176/1,127) on prior LABA or LAMA monotherapy and 18% (175/966) on prior LABA/LAMA dual therapy had a readmission within 30 days of discharge. Conclusions Rates of 30-day readmission were substantial and did not vary considerably based on the maintenance regimen, including ICS-containing dual and triple therapies prescribed postdischarge. Additionally, real-world use of ICS does not reflect GOLD guideline recommendations for lower use of ICS in COPD patients with lower BEC. This abstract is funded by: This study was funded by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA.
Saxena et al. (Fri,) studied this question.