Prompt treatment with Breztri Aerosphere lowers exacerbation risk

2,409 COPD patients in EROS registry were included in analysis at ATS presentation

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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Prompt treatment with Breztri Aerosphere (budesonide/glycopyrronium/formoterol fumarate) after a moderate or severe chronic obstructive pulmonary disease (COPD) exacerbation can lower the risk of a future worsening episodes.

That’s according to data by AstraZeneca, which markets Breztri Aerosphere, in the late-breaking abstract, “Exacerbations and Real-world Outcomes (EROS) Among Patients With COPD Receiving Single Inhaler Triple Therapy of Budesonide/glycopyrrolate/formoterol Fumarate,” which was presented at the American Thoracic Society (ATS) 2023 International Conference this month in Washington, D.C.

The findings “build on the body of clinical evidence that Breztri is effective in reducing COPD exacerbation rates and can significantly reduce the risk of future exacerbations if used as soon as a patient’s COPD symptoms worsen,” Charlie Strange, MD, a professor at the Medical University of South Carolina and study investigator, said in a company press release.

An exacerbation or flare-up happens when symptoms suddenly worsen. Sometimes this is related to an infection, but other times the cause isn’t known.

Breztri Aerosphere, an inhaled therapy containing a combination of an anti-inflammatory compound alongside two molecules that help open up the airways, was approved to treat COPD in the U.S. in 2020 based on clinical trial data suggesting it could reduce the risk of exacerbations.

The ATS presentation included an analysis from 2,409 patients followed as part of a real-world registry study, called EROS. All the patients had a moderate or severe exacerbation and were treated with Breztri.

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Prompt vs. delayed treatment with Breztri Aerosphere

Patients were divided into three groups based on the timing of treatment: 434 received prompt treatment, starting within a month of the exacerbation. Another 1,187 had delayed treatment, starting between one and six months after the exacerbation. The remaining 788 were very delayed and started Breztri more than six months after an exacerbation.

Among those given prompt treatment, the mean rate of future exacerbations was 1.52 per year, follow-up data showed. The future exacerbation rate was two a year for patients with delayed treatment and 2.3 a year with very delayed treatment. That amounts to a 24% lower relapse risk with prompt treatment over delayed treatment and a 34% lower risk over very delayed treatment.

Rates of exacerbations deemed to be severe were similarly lower with prompt treatment over delayed treatment and the findings were similar regardless of the type of inhalers patients were using before starting Breztri.

“EROS was able to show that [Breztri] decreased future exacerbations regardless of the type of baseline inhalers being used prior to triple therapy. This gives us insight that triple therapies may be cost effective to a health system because of the ability to reduce the risk of future exacerbations when given to patients at the time of both moderate and severe exacerbations of COPD,” Strange said in an email to COPD News Today.

In a separate presentation, researchers analyzed insurance data to provide more insight on the health consequences of acute COPD exacerbations. The presentation was titled, “Incidence of Severe Cardiovascular Events Following Acute Exacerbation of Chronic Obstructive Pulmonary Disease in a Large Claims Database.”

The analysis included data on 355,978 people diagnosed with COPD between 2012-2019, of whom 145,838 had at least one exacerbation.

Results showed that, in the month after an exacerbation, the risk of an acute cardiovascular event (e.g., heart attack or stroke) was significantly increased by 32%. The risk of a cardiovascular event was higher after a severe exacerbation compared with a moderate exacerbation and remained elevated at least a year after the exacerbation.

“Our new data at ATS further highlight the cardiopulmonary risk of COPD exacerbations, with COPD increasing the risk both in the lung and heart,” said Robert Fogel, MD, vice president of global medical affairs, respiratory and immunology at AstraZeneca.

The results “demonstrate that the occurrence of severe cardiovascular events, including heart attack, heart failure and stroke, was increased by 32 percent after a single moderate or severe exacerbation of COPD, particularly in the first 90 days, and this risk stayed elevated for an entire year, even in those newly diagnosed with COPD,” Fogel said. “What these data tell us is that we need to treat COPD exacerbations as the urgent events they are and prioritize prompt, proactive treatment to prevent them from occurring.”