{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T00:53:32Z","timestamp":1775868812395,"version":"3.50.1"},"reference-count":30,"publisher":"European Respiratory Society (ERS)","issue":"2","license":[{"start":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T00:00:00Z","timestamp":1687305600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.ersjournals.com\/user-licence"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2023,6,12]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Single-inhaler dual bronchodilators are now recommended as initial treatment of COPD for patients with multiple exacerbations or with moderate or severe dyspnoea. It is unclear whether there are differences in effectiveness among commonly used dual bronchodilators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified a cohort of COPD patients, aged \u226540\u2005years, treated during 2017\u20132020, from the UK Clinical Practice Research Datalink, a real-world practice setting. Inhaled corticosteroid-na\u00efve patients initiating vilanterol\u2013umeclidinium (VIL\u2013UME) were compared with those initiating olodaterol\u2013tiotropium (OLO\u2013TIO) or indacaterol\u2013glycopyrronium (IND\u2013GLY) dual bronchodilators primarily on the incidence of moderate and severe COPD exacerbation over 1\u2005year, and corresponding hazard ratios (HRs), after adjustment by propensity score weighting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cohort included 15\u2009224 initiators of VIL\u2013UME, 5536 initiators of OLO\u2013TIO and 5059 initiators of IND\u2013GLY. The HR of a moderate or severe exacerbation with VIL\u2013UME was 0.91 (95% CI 0.85\u20130.97) compared with OLO\u2013TIO and 0.96 (95% CI 0.89\u20131.03) compared with IND\u2013GLY. The risk of severe exacerbation was not different for VIL\u2013UME when compared with OLO\u2013TIO (HR 1.04, 95% CI 0.86\u20131.26) and IND\u2013GLY (HR 1.05, 95% CI 0.86\u20131.28). All-cause mortality was lower with VIL\u2013UME compared with IND\u2013GLY (HR 0.82, 95% CI 0.68\u20130.98), but not compared with OLO\u2013TIO (HR 0.87, 95% CI 0.72\u20131.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a real-world setting of COPD treatment, the three dual bronchodilator combinations were similarly effective on the risk of a severe exacerbation of COPD. However, the VIL\u2013UME and IND\u2013GLY combinations may confer slightly superior effectiveness than OLO\u2013TIO on the risk of moderate or severe exacerbation. The potential lower mortality with VIL\u2013UME warrants further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1183\/13993003.00538-2023","type":"journal-article","created":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T08:40:20Z","timestamp":1687336820000},"page":"2300538","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Real-world comparative effectiveness of three single-inhaler dual bronchodilators for the treatment of COPD"],"prefix":"10.1183","volume":"62","author":[{"given":"Jiaying","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Dell'Aniello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9983-3608","authenticated-orcid":false,"given":"Pierre","family":"Ernst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1281-5296","authenticated-orcid":false,"given":"Samy","family":"Suissa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"81","published-online":{"date-parts":[[2023,6,21]]},"reference":[{"key":"2024102103162595000_62.2.2300538.1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030442"},{"key":"2024102103162595000_62.2.2300538.2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00239-2023"},{"key":"2024102103162595000_62.2.2300538.3","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.2147\/COPD.S378486","article-title":"Single-inhaler triple versus dual bronchodilator therapy in COPD: real-world comparative effectiveness and safety","volume":"17","author":"Suissa","year":"2022","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2024102103162595000_62.2.2300538.4","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.2147\/COPD.S365480","article-title":"Characterization of patients with chronic obstructive pulmonary disease initiating single-inhaler long-acting muscarinic antagonist\/long-acting \u03b22-agonist dual therapy in a primary care setting in England","volume":"17","author":"Requena","year":"2022","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2024102103162595000_62.2.2300538.5","doi-asserted-by":"publisher","DOI":"10.1177\/1753465815624612"},{"key":"2024102103162595000_62.2.2300538.6","doi-asserted-by":"crossref","first-page":"3115","DOI":"10.2147\/COPD.S170606","article-title":"LABA\/LAMA fixed-dose combinations in patients with COPD: a systematic review","volume":"13","author":"Rogliani","year":"2018","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2024102103162595000_62.2.2300538.7","doi-asserted-by":"crossref","first-page":"141","DOI":"10.2147\/COPD.S116719","article-title":"Dual bronchodilation in COPD: lung function and patient-reported outcomes \u2013 a review","volume":"12","author":"Price","year":"2016","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2024102103162595000_62.2.2300538.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2016.02.646"},{"key":"2024102103162595000_62.2.2300538.9","doi-asserted-by":"crossref","first-page":"4961","DOI":"10.1007\/s12325-022-02234-x","article-title":"Comparative efficacy of umeclidinium\/vilanterol versus other bronchodilators for the treatment of chronic obstructive pulmonary disease: a network meta-analysis","volume":"39","author":"Ismaila","year":"2022","journal-title":"Adv Ther"},{"key":"2024102103162595000_62.2.2300538.10","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/j.chest.2022.11.027","article-title":"Comparison of clinical outcomes among different fixed-dose combinations of long-acting muscarinic antagonists and long-acting \u03b22-agonists in patients with COPD","volume":"163","author":"Weng","year":"2023","journal-title":"Chest"},{"key":"2024102103162595000_62.2.2300538.11","unstructured":"Clinical Practice Research Datalink . 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