000165513 001__ 165513
000165513 005__ 20260112132214.0
000165513 0247_ $$2doi$$a10.1159/000549626
000165513 0248_ $$2sideral$$a147100
000165513 037__ $$aART-2025-147100
000165513 041__ $$aeng
000165513 100__ $$0(orcid)0000-0003-0777-3850$$aMarín-Oto, Marta$$uUniversidad de Zaragoza
000165513 245__ $$aImpact of increased single-inhaler triple therapy use in appropriate patients on COPD exacerbations, mortality, and medical costs: PROMETHEUS Spain.
000165513 260__ $$c2025
000165513 5060_ $$aAccess copy available to the general public$$fUnrestricted
000165513 5203_ $$aIntroduction: COPD is the third cause of death in Spain. The ETHOS (NCT02465567) and IMPACT (NCT02164513) RCTs showed reduced exacerbations and all-cause mortality for single-inhaler triple therapy (SITT), but no studies have evaluated the potential impact on COPD outcomes of higher SITT adoption in Spain.
Methods: We used literature-based data on patient characteristics, incidence, COPD severity changes, treatment distributions/transitions, mortality, exacerbations, and medical costs, to inform a stochastic simulation of the Spanish COPD population for 2025-2034 under two scenarios: “Status Quo” and “Increased SITT”, in which higher SITT use is driven by airflow limitation, exacerbation history (as per 2025 GOLD guidelines) and SITT replacing multiple-inhaler triple therapy (MITT). Additionally, we present results separately for the subset of patients that met the criteria for SITT use, referred to as “flagged population.”
Results: In our 10-year simulation, increased SITT use in the flagged population could lead to 51,000 deaths avoided resulting in a 14.6% reduction in mortality rates and extended patient life by 1.2 years per COPD flagged patient. Additionally, increased SITT use in the flagged population reduced severe and moderate exacerbations by 62,000 (an 11.5% reduction) and 366,000 (an 11.6% reduction), respectively, resulting in total medical savings of €384 million.
Conclusion: Based on our simulation, increased use of SITT in the Spanish COPD population, consistent with the most recent 2025 GOLD guidelines’ recommendations, could reduce mortality and exacerbations and their corresponding medical costs. Increasing SITT utilization in patients with COPD may constitute a long-term strategy with relevant clinical and economic benefits.
000165513 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc$$uhttps://creativecommons.org/licenses/by-nc/4.0/deed.es
000165513 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000165513 700__ $$aMestre-Ferrándiz, Jorge
000165513 700__ $$aSánchez-Covisa, Joaquín
000165513 700__ $$aCorregidor García, Carmen
000165513 700__ $$aMartínez-Martínez, Néstor
000165513 700__ $$aBell, John
000165513 700__ $$aCaplen, Melissa
000165513 700__ $$aBhatt, Prachi D.
000165513 700__ $$aCarioto, Jennifer
000165513 700__ $$aPyenson, Bruce
000165513 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000165513 773__ $$g(2025), 1-18$$pRespiration$$tRESPIRATION$$x0025-7931
000165513 8564_ $$s3469105$$uhttps://zaguan.unizar.es/record/165513/files/texto_completo.pdf$$yVersión publicada
000165513 8564_ $$s1257749$$uhttps://zaguan.unizar.es/record/165513/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000165513 909CO $$ooai:zaguan.unizar.es:165513$$particulos$$pdriver
000165513 951__ $$a2026-01-12-11:08:59
000165513 980__ $$aARTICLE