title: Risk of all-cause hospitalization in COPD patients initiating long-acting or short-acting beta agonist therapy.
abstract: OBJECTIVE
  This retrospective claims study investigated the rates of all-cause hospitalization among chronic obstructive pulmonary disease (COPD) patients initiating treatment with short-acting beta agonists (SABA) or long-acting beta agonists (LABA).
  
  
  METHODS
  Data from the 5% national sample of Medicare enrollees for 2006-2008 were used. Patients initiating COPD therapy were identified as those with no COPD therapy for ≥ 6-months prior to initiating SABA or LABA (administered via dry-powder inhalers, metered-dose inhalers, or nebulizer) treatment. All patients were continuously eligible for Medicare Parts A, B, and D for 18 months. Those enrolled in Medicare Advantage, who had asthma, or were < 65 years old were excluded. Differences in the rates of all-cause hospitalizations and time to all-cause hospitalization during the 6-month follow-up period were examined, while adjusting for demographics, clinical indicators, and health service use.
  
  
  RESULTS
  Among 3017 COPD patients who met the inclusion criteria, 883 (30%) were LABA users and 2134 (70%) were SABA users. Overall, 21% of patients (16% [144/883] of LABA and 23% [492/2134] of SABA) had a hospitalization during the follow-up period. Mean time to hospitalization was 86 days for LABA vs 64 days for SABA patients (p < 0.05). The adjusted hazard ratio for hospitalization in a Cox proportional hazards model was 0.74 (95% CI = 0.62-0.90) for patients treated with LABA vs. SABA.
  
  
  CONCLUSIONS
  The analysis was adjusted for multiple background characteristics, but important measures of severity in COPD, such as measures of lung functioning, were not available and may have differed between patients treated with LABA or SABA.
  
  
  CONCLUSIONS
  The results of this analysis indicate COPD patients initiating LABA treatment had a longer time to all-cause hospitalization and a 26% lower risk of hospitalization during the 6-months follow-up period compared to those initiating SABA therapy.
authors.affiliation: Sunovion Pharmaceuticals, Inc., Marlborough, MA 01752, USA. vamsi.bollu@sunovion.com
authors.forename: Vamsi
authors.initials: V
authors.lastname: Bollu
authors.forename: Flavia
authors.initials: F
authors.lastname: Ejzykowicz
authors.forename: Krithika
authors.initials: K
authors.lastname: Rajagopalan
authors.forename: John
authors.initials: J
authors.lastname: Karafilidis
authors.forename: Joel W
authors.initials: JW
authors.lastname: Hay
mesh_terms: D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003692:Delayed-Action Preparations; D005260:Female; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D009330:Nebulizers and Vaporizers; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States
chemical_list: D000318:Adrenergic beta-Agonists; D003692:Delayed-Action Preparations