{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T04:02:43Z","timestamp":1784520163707,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,4]],"date-time":"2026-01-04T00:00:00Z","timestamp":1767484800000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Our objective was to estimate the effect of initiating an inhaled corticosteroids\u2010containing single\u2010inhaler triple agent (ICS\u2010LABA\u2010LAMA) compared with a single\u2010inhaler LABA\u2010LAMA dual bronchodilator in patients with COPD on the risk of severe COVID\u201019 prior to the roll\u2010out of vaccines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cohort study emulating a randomized trial, among patients with COPD aged 40\u2009years or more in the UK, comparing those who initiated a triple inhaler with those who initiated a dual bronchodilator inhaler between March 1 and December 31, 2020. Weighting by fine stratification of the propensity score was used to account for confounders. The risk of hospitalized COVID\u201019 was compared with a Cox proportional hazards model in an as\u2010treated analysis with a 30\u2010day grace period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study cohort included 876 patients initiating a triple inhaler\u00a0and 5010 initiating a dual LABA\u2010LAMA inhaler. The adjusted incidence rate of hospitalized COVID\u201019 was 5.6 per 100 person\u2010years in the triple inhaler group and 2.9 per 100 person\u2010years in the dual inhaler group, with a corresponding hazard ratio (HR) of 1.96 (95% confidence interval 1.01\u20133.77). Sensitivity analyses on the duration of the grace period, using an intent\u2010to\u2010treat exposure classification, or starting follow\u2010up 14\u2009days after treatment initiation (accounting for treatment initiation for an undocumented SARS\u2010CoV\u20102 infection) were generally consistent with the main analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with COPD prescribed an ICS\u2010containing triple inhaler were potentially exposed to an increased risk of severe COVID\u201019 prior to the vaccine era. As SARS\u2010CoV\u20102 continues to cause significant burden, these findings should be considered when determining initiation of inhaled treatment in COPD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70321","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T01:08:10Z","timestamp":1767575290000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of Hospitalized\n                    <scp>COVID<\/scp>\n                    \u201019 in\n                    <scp>COPD<\/scp>\n                    : Single\u2010Inhaler Triple Versus Dual Bronchodilator Therapy"],"prefix":"10.1002","volume":"35","author":[{"given":"Simon","family":"Galmiche","sequence":"first","affiliation":[{"name":"Center for Clinical Epidemiology, Lady Davis Institute (LDI) Jewish General Hospital  Montreal Canada"},{"name":"Department of Epidemiology, Biostatistics and Occupational Health McGill University  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Dell'Aniello","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology, Lady Davis Institute (LDI) Jewish General Hospital  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1281-5296","authenticated-orcid":false,"given":"Samy","family":"Suissa","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology, Lady Davis Institute (LDI) Jewish General Hospital  Montreal Canada"},{"name":"Department of Epidemiology, Biostatistics and Occupational Health McGill University  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00239\u20102023"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2023.08.014"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S378486"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1713901"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-018-04574-1"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30415-X"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S404913"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(21)00013-8"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.70086"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30447-1"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00883-2023"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2009.03537.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv098"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S117867"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-073866"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/15412555.2021.1982886"}],"container-title":["Pharmacoepidemiology and Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.70321","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pds.70321","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.70321","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T03:24:25Z","timestamp":1784517865000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pds.70321"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/pds.70321"],"URL":"https:\/\/doi.org\/10.1002\/pds.70321","archive":["Portico"],"relation":{},"ISSN":["1053-8569","1099-1557"],"issn-type":[{"value":"1053-8569","type":"print"},{"value":"1099-1557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-09-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70321"}}