Comparison of initial drug treatment of incident COPD patients with German treatment guidelines

Introduction: The current German COPD guidelines recommends a treatment escalation procedure. Initial treatment should generally not include use of ICS. Aims and objectives: This claims data analysis aims to find out whether real-world first-line treatment of newly diagnosed COPD patients in Germany was in line with national 2018 COPD guideline recommendations. Methods: Claims data from incident COPD patients were analyzed retrospectively from 04/2014-03/2019. Continuously insured non-asthmatic patients ≥ 40 years, who had received ≥ 2 outpatient specialist’s diagnoses and/or ≥ 1 inpatient COPD diagnosis with 12-month follow-up were included. Patients not treated in line with 2018 German treatment guidelines were determined by the percentage of patients with any ICS therapy within 4 weeks after initial diagnosis as well as the percentage of patients with LAMA/LABA/ICS prescription but ≤ 1 outpatient diagnosis and no inpatient diagnosis of an exacerbation (ICD-10 J44.1) at the first date of the LAMA/LABA/ICS prescription. Results: Data were analyzed from 14,213 patients with newly diagnosed COPD (mean age: 70.1, females: 41.2%). 14.1% (n=2,008) of the patients received an ICS-containing therapy within 4 weeks after the initial diagnosis. 1,019 incident patients were prescribed a LAMA/LABA/ICS therapy within 12 months after diagnosis, of these, 68.9% (n=702) patients had ≤ 1 outpatient diagnosis and no inpatient diagnosis of an exacerbation. Conclusion: The majority of initial prescriptions for newly diagnosed COPD patients were in line with current COPD guideline recommendations, however the use of triple therapy was not consistent with COPD patient exacerbation risk.