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Observational Study
. 2025 Apr 18:20:1131-1142.
doi: 10.2147/COPD.S495086. eCollection 2025.

Characteristics of Patients Initiated on Budesonide/Glycopyrronium Bromide/Formoterol Fumarate Single Inhaler Triple Therapy for the Treatment of Chronic Obstructive Pulmonary Disease: A Population-Based Observational Study

Gaétan Deslee  1 , Caroline Fabry-Vendrand  2 , Elsa Salmi  2 , Nolwenn Poccardi  2 , Adrien Coriat  3 , Idir Ghout  3 , Caroline Eteve-Pitsaer  3 , Nicola J Adderley  4 , Henri Leleu  5
Affiliations
Observational Study

Characteristics of Patients Initiated on Budesonide/Glycopyrronium Bromide/Formoterol Fumarate Single Inhaler Triple Therapy for the Treatment of Chronic Obstructive Pulmonary Disease: A Population-Based Observational Study

Gaétan Deslee et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Background: Budesonide/glycopyrronium bromide/formoterol fumarate (BUD/GLY/FOR) single inhaler triple therapy became available to prescribe to patients with severe chronic obstructive pulmonary disease (COPD) in France in 2021. The characteristics of patients prescribed BUD/GLY/FOR triple therapy and guideline adherence have not been previously described in France.

Objective: To describe the characteristics of COPD patients initiated on BUD/GLY/FOR triple therapy, assess adherence to COPD management guidelines, and explore any differences by prescribing physician.

Materials and methods: A cross-sectional study using data from The Health Improvement Network (THIN®) France database was conducted. Patients with ≥2 recorded diagnostic codes for COPD were included. Demographic characteristics, comorbidities, management, COPD-related characteristics, and guideline adherence (Société de Pneumologie de Langue Française (SPLF); Haute Autorité de Santé (HAS)), stratified by initiating physician speciality (general practitioner (GP) or pulmonologist) were described.

Results: A total of 263 patients initiating BUD/GLY/FOR triple therapy were included. Mean (SD) age was 68.8 (11.8) years; 53.6% were male. Mean (SD) COPD duration was 6.4 (5.5) years. Comorbidities were common, with slightly more cardiometabolic and mental health conditions recorded in the GP-initiated group, and more comorbid respiratory conditions recorded in the pulmonologist-initiated group. About 77.2% (n=203) of patients had at least one moderate or severe exacerbation in the 12 months before initiation. About 86.3% had a previous record of dual (n=117, 44.5%) or triple (n=110, 41.8%) therapy. About 68.8% had been initiated on BUD/GLY/FOR triple therapy in line with SPLF guidelines (62.4% and 72.4% in the GP- and pulmonologist-initiated groups, respectively); among those with a record of COPD severity, 75.2% were initiated in line with HAS guidelines (69.2% and 76.3% in the GP- and pulmonologist-initiated groups, respectively).

Conclusion: The majority of COPD patients are prescribed BUD/GLY/FOR triple therapy in accordance with current treatment guidelines, irrespective of whether the therapy is prescribed by a general practitioner or a pulmonologist.

Keywords: budesonide/glycopyrronium bromide/formoterol fumarate; chronic obstructive pulmonary disease; management; triple therapy.

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Conflict of interest statement

GD reports personal fees from Chiesi, Boehringer Ingelheim, GSK, Sanofi and AstraZeneca. CFV, ES and NP are employees of AstraZeneca. AC and CEP are employees of Cegedim. NJA is an independent consultant at the University of Birmingham. She also reports personal fees from Cegedim, during the conduct of the study; grants from the National Institute for Health Research, outside the submitted work. HL reports personal fees from Cegedim, during the conduct of the study; personal fees from AstraZenaca, outside the submitted work. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Schema of study period and participant inclusion.
Figure 2
Figure 2
Flow diagram of the included study population.
See this image and copyright information in PMC

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