Abstract Rationale Real-world evidence on medication adherence to single-inhaler triple therapy (SITT) for chronic obstructive pulmonary disease (COPD) in Japan remains limited. This study evaluated adherence to two SITT regimens—fluticasone furoate/umeclidinium/vilanterol (FUV) and budesonide/glycopyrronium/formoterol (BGF)—in routine clinical practice. Methods We analyzed data from 4,077 patients aged ≥40 years with COPD who newly initiated FUV or BGF between April 2020 and March 2022 in 19 municipalities participating in the LIFE Study, a population-based cohort linking health insurance and medical assistance claims. The proportion of days covered (PDC) was calculated for each patient, and good adherence was defined as PDC ≥0.8. Patients were categorized into the FUV (n = 2,373) and BGF (n = 1,704) groups. Multivariable-adjusted risk ratios (RRs) and 95% confidence intervals (CIs) for good adherence associated with FUV versus BGF were estimated using modified Poisson regression models. Results The median PDC was 0.69 in the FUV group and 0.45 in the BGF group. The proportions of patients with good adherence were 42.6% and 27.8%, respectively. After adjustment, the multivariable-adjusted RR for good adherence to SITT for FUV versus BGF was 1.39 (95% CI, 1.28-1.51). Conclusions In real-world COPD care in Japan, FUV therapy was associated with a higher likelihood of good adherence compared with BGF therapy. However, irrespective of the regimen, more than half of patients demonstrated poor adherence during the follow-up period. Strategies to enhance long-term adherence to inhaled therapy are urgently needed to optimize COPD management. This abstract is funded by: Japan Science and Technology Agency FOREST Program (Grant Number JPMJFR205J)
Ogata et al. (Fri,) studied this question.