Late Breaking Abstract - Pneumonia risk in COPD patients initiating extrafine Fixed Dose Combination (FDC) with beclometasone dipropionate (ef-FDC-BDP) versus long-acting bronchodilators (LABD)

Background: The use of extrafine inhaled corticosteroid (ICS) formulations in COPD treatment reduce exacerbations and allow lower doses possibly reducing pneumonia risk. Aim: Compare pneumonia risk in COPD patients prescribed ef-FDC-BDP to those prescribed LABD alone. Methods: Propensity matched historical cohort study was conducted using data from Optimum Patient Care Research Database. COPD patients aged ≥40 years with ≥1 year of continuous medical data who initiated ef-FDC-BDP or LABD were compared. Time to event analysis whilst on treatment was used to estimate pneumonia risk, as sensitive (physician-diagnosed) and specific (physician-diagnosed and x-ray or hospital admission confirmed) definition. Assessment of non-inferiority was conducted (upper boundary 15%). Results: A total of 10,284 patients were matched. Initiation of ef-FDC-BDP was not associated with any difference in risk of pneumonia although non-inferiority criteria were not met: sensitive HR 0.95 (0.75-1.19); specific definition HR 0.97 (0.76-1.24) versus LABD. Conclusion: No significant differences were observed between ef-FDC-BDP and LABD pneumonia risk in propensity score matched analyses but non-inferiority was not reached.