1. Global Initiative for Chronic Obstructive Lung Disease. Strategy Report 2023. Available at:
https://goldcopd.org/. Last accessed: November 2022;
2. Vestbo J, et al. Int J Chron Obstruct Pulmon Dis 2019;14:853–861;
3. Tzanakis N, et al. BMC Pulm Med 2021;21:216;
4. Jones RCM, et al. Lancet Respir Med 2014;2:267–276;
5. Spiolto Respimat SmPC. Updated September 2021;
6. Zierenberg B. J Aerosol Med 1999;12(suppl 1):S19-S24;
7. Anderson P. Int J Chron Obstruct Pulmon Dis 2006;1:251–259;
8. Singh D et al. Respir Med 2015;109:1312-1319;
9. Troosters T et al. Am J Respir Crit Care Med 2018;198:1021–1032;
10. Loh CH, et al. Ann Am Thorac Soc 2017;14:1305–1311;
11. Kocks JWH, et al. NPJ Prim Care Respir Med 2022;32:18;
12. Anzueto A & Miravitlles M. Respir Res 2020;21:199;
13. Mahler DA, et al. Int J Chron Obstruct Pulmon Dis 2021;16:2455–2465;
14. Müllerová H, et al. PLoS One 2014;9:e85540;
15. Kardos P, et al. Resp Med 2017;124:57–64;
16. Miravitlles M, et al. Respir Res 2017;18:198;
17. Suissa S, et al. COPD 2022;19:1–9.
* Consider LAMA+LABA+ICS in patients with 2 or more moderate/1 severe exacerbation in the last year if blood eosinophils are ≥300 cells/μL (practical recommendation).
† European data from the Adelphi Real World Respiratory Disease Specific Programme™ 2017 survey (N=1528) in which 10.6% of patients had a history of ≥2 moderate/severe exacerbations and eosinophils ≥300 cells/µL.
‡ If patients with COPD have concomitant asthma, they should be treated like patients with asthma. Under these circumstances, the use of ICS is mandatory.
§ Data from a cross-sectional observational study in Greece (N=3615) and a retrospective clinical cohort study in the UK (N=38,859). Classification of patients based on the ABCD assessment tool.
¶ Retrospective chart review of patients hospitalised for an acute exacerbation of COPD (N=123). Disease severity based upon GOLD classification; patients across all ranges of severity were included. Suboptimal PIF was defined as ≤60 L/min.
# Cross-sectional observational real-world study in patients with COPD on maintenance DPI therapy for ≥3 months (N=1434). Suboptimal PIF defined as typical PIF lower than required for the device. Suboptimal vs. optimal PIF associated with worse CCQ score (p=0.001) and higher severe exacerbation rate (p=0.167).
|| Randomised, placebo-controlled study of TIO/OLO delivered via SMI™ in patients with COPD stratified by PIF (N=213). SPIOLTO® RESPIMAT® significantly improved lung function vs. placebo, irrespective of PIF (p<0.0001).
** COPD patients identified from the Clinical Practice Research Datalink with ≥1 MRC dyspnoea grade recorded (N=49,438).
†† Observational real-world study (N=6122).
‡‡ All-cause mortality adjusted HR 1.17 (95% CI 1.04–1.31); severe exacerbation adjusted HR 1.19 (95% CI 1.08–1.32). Real-world study of COPD patients aged ≥50 years, treated from 2002–2018, identified from the UK Clinical Practice Research Datalink. The cohort included 117,729 new users of LAMA/LABA/ICS and 26,666 of LAMA/LABA.
2. Vestbo J, et al. Int J Chron Obstruct Pulmon Dis 2019;14:853–861;
3. Tzanakis N, et al. BMC Pulm Med 2021;21:216;
4. Jones RCM, et al. Lancet Respir Med 2014;2:267–276;
5. Spiolto Respimat SmPC. Updated September 2021;
6. Zierenberg B. J Aerosol Med 1999;12(suppl 1):S19-S24;
7. Anderson P. Int J Chron Obstruct Pulmon Dis 2006;1:251–259;
8. Singh D et al. Respir Med 2015;109:1312-1319;
9. Troosters T et al. Am J Respir Crit Care Med 2018;198:1021–1032;
10. Loh CH, et al. Ann Am Thorac Soc 2017;14:1305–1311;
11. Kocks JWH, et al. NPJ Prim Care Respir Med 2022;32:18;
12. Anzueto A & Miravitlles M. Respir Res 2020;21:199;
13. Mahler DA, et al. Int J Chron Obstruct Pulmon Dis 2021;16:2455–2465;
14. Müllerová H, et al. PLoS One 2014;9:e85540;
15. Kardos P, et al. Resp Med 2017;124:57–64;
16. Miravitlles M, et al. Respir Res 2017;18:198;
17. Suissa S, et al. COPD 2022;19:1–9.
* Consider LAMA+LABA+ICS in patients with 2 or more moderate/1 severe exacerbation in the last year if blood eosinophils are ≥300 cells/μL (practical recommendation).
† European data from the Adelphi Real World Respiratory Disease Specific Programme™ 2017 survey (N=1528) in which 10.6% of patients had a history of ≥2 moderate/severe exacerbations and eosinophils ≥300 cells/µL.
‡ If patients with COPD have concomitant asthma, they should be treated like patients with asthma. Under these circumstances, the use of ICS is mandatory.
§ Data from a cross-sectional observational study in Greece (N=3615) and a retrospective clinical cohort study in the UK (N=38,859). Classification of patients based on the ABCD assessment tool.
¶ Retrospective chart review of patients hospitalised for an acute exacerbation of COPD (N=123). Disease severity based upon GOLD classification; patients across all ranges of severity were included. Suboptimal PIF was defined as ≤60 L/min.
# Cross-sectional observational real-world study in patients with COPD on maintenance DPI therapy for ≥3 months (N=1434). Suboptimal PIF defined as typical PIF lower than required for the device. Suboptimal vs. optimal PIF associated with worse CCQ score (p=0.001) and higher severe exacerbation rate (p=0.167).
|| Randomised, placebo-controlled study of TIO/OLO delivered via SMI™ in patients with COPD stratified by PIF (N=213). SPIOLTO® RESPIMAT® significantly improved lung function vs. placebo, irrespective of PIF (p<0.0001).
** COPD patients identified from the Clinical Practice Research Datalink with ≥1 MRC dyspnoea grade recorded (N=49,438).
†† Observational real-world study (N=6122).
‡‡ All-cause mortality adjusted HR 1.17 (95% CI 1.04–1.31); severe exacerbation adjusted HR 1.19 (95% CI 1.08–1.32). Real-world study of COPD patients aged ≥50 years, treated from 2002–2018, identified from the UK Clinical Practice Research Datalink. The cohort included 117,729 new users of LAMA/LABA/ICS and 26,666 of LAMA/LABA.
PC-CRP-104007 - November 2022 