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Outcomes From Initial Maintenance Therapy With Fluticasone Propionate 250/Salmeterol 50 (FSC) or Tiotropium in Chronic Obstructive Pulmonary Disease

Information source: GlaxoSmithKline
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Pulmonary Disease, Chronic Obstructive

Intervention: fluticasone propionate/salmeterol 250µg/50µg (FSC) (Drug); tiotropium bromide (TIO) (Drug)

Phase: N/A

Status: Completed

Sponsored by: GlaxoSmithKline

Official(s) and/or principal investigator(s):
GSK Clinical Trials, Study Director, Affiliation: GlaxoSmithKline


Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow limitation caused by inflammation-mediated damage to lung tissue. Although damage to lung tissue in COPD appears to be irreversible, evidence suggests that the course of COPD can be altered through measures such as smoking cessation, pulmonary rehabilitation, and the use of pharmacotherapy for bronchodilation. A primary goal of maintenance pharmacotherapy is to reduce the incidence of acute exacerbations and the associated hospitalizations and emergency department (ED) visits. Bronchodilation in COPD maintenance therapy can be accomplished with the long-acting anticholinergic tiotropium (TIO), long acting beta-agonists (e. g. formoterol, salmeterol), methylxanthines (e. g. theophylline), or combination therapy with a long-acting beta-agonist and an inhaled corticosteroid (e. g. fluticasone propionate/salmeterol [FSC]). The objective of this study is to compare the benefits of combination long-acting beta-agonist/inhaled corticosteroid therapy to long-acting anticholinergic therapy. The study compares the risk of COPD exacerbations and COPD-related healthcare utilization and costs for commercially-insured patients age 40 and older who were prescribed FSC to those prescribed TIO. The null hypothesis is that no difference exists between the costs and outcomes of COPD patients treated with TIO and those treated with FSC. The test hypothesis is that patients treated with either TIO or FSC will incur lower costs and use fewer healthcare resources for the management of COPD. The source of data for this study was the Ingenix Impact database (formerly the Integrated Healthcare Information Services [IHCIS] database). This is an administrative claims database that includes patient-level data on enrollment, facility, professional, and pharmacy services from approximately 50 million patients covered by more than 40 managed care health plans across the United States (US). The study design is a retrospective cohort study.

Clinical Details

Official title: Outcomes From Initial Maintenance Therapy With Fluticasone Propionate 250/Salmeterol 50 (FSC) or Tiotropium in Chronic Obstructive Pulmonary Disease

Study design: Observational Model: Cohort, Time Perspective: Retrospective

Primary outcome:

Post-index Period COPD-related, Unadjusted Costs

Mean Number of COPD Exacerbations

Secondary outcome: Number of COPD-related Healthcare Encounters


Minimum age: 40 Years. Maximum age: N/A. Gender(s): Both.


Inclusion Criteria:

- Patient is age 40 or older

- Patient record indicates a new prescription claim for fluticasone

propionate/salmeterol (FSC) or tiotropium bromide (TIO) (first pharmacy claim defines the index date)

- Patient records include at least two medical claims with a primary or non-primary

diagnosis of COPD (International Classification of Disease-9 [ICD-9] code 490. xx -

492. xx or 496. xx)

- At least one of the patient's ICD-9 codes for COPD is observed in the 12 months prior

to the first pharmacy claim for FSC or TIO (the index date) Exclusion Criteria:

- A pharmacy claim for FSC or TIO prior to the index date

- The patient initiated FSC at a dose other than 250µg/50µg

- The patient initiated FSC and TIO at the same time

- The patient had one or more prescription with missing dosing information

- The patient had a prescription claim for the study medication other than the one they

started on at the index date within 60 days after the index date

Locations and Contacts

Additional Information

Starting date: July 2008
Last updated: November 23, 2011

Page last updated: August 23, 2015

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