Imperial College London
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ProfessorJenniferQuint

Faculty of Medicine, School of Public Health

Professor of Respiratory Epidemiology
 
 
 
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Contact

 

+44 (0)20 7594 8821j.quint

 
 
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Location

 

.922Sir Michael Uren HubWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{wing:2021:10.1183/13993003.01586-2020,
author = {wing, K and williamson, E and carpenter, J and wise, L and schneeweiss, S and smeeth, L and Quint, J and douglas, I},
doi = {10.1183/13993003.01586-2020},
journal = {European Respiratory Journal},
pages = {1--13},
title = {Real world effects of COPD medications: a cohort study with validation against results from randomised controlled trials},
url = {http://dx.doi.org/10.1183/13993003.01586-2020},
volume = {57},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Real-world data provide the potential for generating evidence on drug treatment effects in groups excluded from trials, but rigorous, validated methodology for doing so is lacking. We investigated whether non-interventional methods applied to real-world data could reproduce results from the landmark TORCH COPD trial.We performed a historical cohort study (2000–2017) of COPD drug treatment effects in the UK Clinical Practice Research Datalink (CPRD). Two control groups were selected from CPRD by applying TORCH inclusion/exclusion criteria and 1:1 matching to TORCH participants: control group 1- people with COPD not prescribed fluticasone propionate-salmeterol (FP-SAL), control group 2- people with COPD prescribed salmeterol (SAL). FP-SAL exposed groups were then selected from CPRD by propensity-score matching to each control group. Outcomes studied were COPD exacerbations, death from any cause and pneumonia.2652 FP-SAL exposed people were propensity-score matched to 2652 FP-SAL unexposed people while 991 FP-SAL exposed people were propensity-score matched to 991 SAL exposed people. Exacerbation rate ratio was comparable to TORCH for FP-SAL versus SAL (0.85, 95% CI 0.74–0.97 versus 0.88, 0.81–0.95) but not for FP-SAL versus no FP-SAL (1.30, 1.19–1.42 versus 0.75, 0.69–0.81). Active comparator results were also consistent with TORCH for mortality (hazard ratio 0.93, 0.65–1.32 versus 0.93, 0.77–1.13) and pneumonia (risk ratio 1.39, 1.04–1.87 versus 1.47, 1.25–1.73).We obtained very similar results to the TORCH trial for active comparator analyses, but were unable to reproduce placebo-controlled results. Application of these validated methods for active comparator analyses to groups excluded from RCTs provides a practical way for contributing to the evidence base and supporting COPD treatment decisions.
AU  - wing,K
AU  - williamson,E
AU  - carpenter,J
AU  - wise,L
AU  - schneeweiss,S
AU  - smeeth,L
AU  - Quint,J
AU  - douglas,I
DO  - 10.1183/13993003.01586-2020
EP  - 13
PY  - 2021///
SN  - 0903-1936
SP  - 1
TI  - Real world effects of COPD medications: a cohort study with validation against results from randomised controlled trials
T2  - European Respiratory Journal
UR  - http://dx.doi.org/10.1183/13993003.01586-2020
UR  - https://erj.ersjournals.com/content/57/3/2001586
UR  - http://hdl.handle.net/10044/1/84347
VL  - 57
ER  -
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