Replication of the POET-COPD Trial in Healthcare Claims Data

This is a non-randomized, non-interventional study that is part of the RCT DUPLICATE initiative (www.rctduplicate.org) of the Brigham and Women's Hospital, Harvard Medical School. It is intended to replicate, as closely as is possible in healthcare insurance claims data, the trial listed below/above. Although many features of the trial cannot be directly replicated in healthcare claims, key design features, including outcomes, exposures, and inclusion/exclusion criteria, were selected to proxy those features from the trial. Randomization is also not replicable in healthcare claims data but was proxied through a statistical balancing of measured covariates according to standard practice. Investigators assume that the RCT provides the reference standard treatment effect estimate and that failure to replicate RCT findings is indicative of the inadequacy of the healthcare claims data for replication for a range of possible reasons and does not provide information on the validity of the original RCT finding.

• Salmeterol (Drug): Salmeterol inhaler dispensing claim is used as the reference
• Tiotropium (Drug): Tiotropium dispensing claim is used as the reference

Primary outcomes

• Time to first COPD exacerbation [[Time Frame: To censoring or study completion, up to 365 days]]: Time to first COPD exacerbation

Secondary outcomes

• All-cause death [[Time Frame: To censoring or study completion, up to 365 days]]: All-cause death

Sex: All, ages: 40 Years to 120 Years

Inclusion Criteria:

* Age greater or equal than 40: days \[0,0\]
* Diagnosis of COPD: days \[-All Data, 0\]
* History of at least 1 COPD exacerbation within the past year requiring treatment with antibiotics and/or systemic steroids and/or requiring hospitalization: days \[-365, -28\]

Exclusion Criteria:

* Patients with 3 diagnosis of asthma: days \[-180, 0\]
* Patients with current severe cardiovascular disorders (Heart Transplantation, LVAD/Implantable heart, Pulmonary hypertension/other pulmonary disease) and use of systemic corticosteroid medication at unstable doses: days \[-365, 0\]
* Patients with any respiratory infection (Acute respiratory infections, pneumonia and influenza) or COPD exacerbation: days \[-28, 0\]
* Exclude use of salmeterol or tiotropium containing inhaler use \[-180, 0\]

• Study Protocol and Statistical Analysis Plan (PDF, 2021-08-10)

• Shirley Wang, PhD, ScM, Principal investigator, Brigham and Women's Hospital