Introduction The prospective, non-interventional DACCORD study collects data from a representative cohort of COPD out-patients across Germany who either initiated or changed COPD maintenance medication prior to entry. Initially, DACCORD consisted of two treatment groups (Glycopyrronium-based therapy vs. any other COPD maintenance medication with the exception of Glycopyrronium). Following the approval of LABA/LAMA fixed-dose combinations (FDC) in 2013, DACCORD was extended to follow an additional cohort of patients receiving any LABA/LAMA FDC over a period of 2 years.
Methods 5223 patients with complete baseline data (3815 LAMA/LABA FDC vs. 1408 standard treatment group) were analysed here. Baseline exacerbations were evaluated 6 months prior to study entry and were annualised for GOLD 2011 categorization; COPD symptoms were evaluated using the COPD Assessment Test (CAT) and the mMRC questionnaire. Prior and concomitant COPD medication were captured and analysed by substance class.
Results Baseline characteristics are summarised in Table 1. Based on FEV1 assessment, approx. 75% of patients suffered from moderate to severe COPD. Less than a quarter of patients reported a history of exacerbations and only 6.7% experienced ≥2 exacerbations in the 6 months prior to study entry. Taking into account airflow limitation, COPD symptoms and exacerbation history, 41.5% of patients were categorised as GOLD D. Prior to study entry 1271 patients did not receive COPD maintenance treatment and ICS was withdrawn from 1307 patients. 86.9% of patients with an exacerbation history in the LABA/LAMA-FDC treatment group did not receive additional ICS while 58.5% of patients with an exacerbation history in the standard therapy arm received an ICS-based treatment regimen.
Conclusions The population recruited has a broad range of disease severity, with a baseline CAT and mMRC mean score suggesting a relatively high degree of symptoms. COPD progression and exacerbations will be recorded over the next 2 years and analysed in relation to the received maintenance medication, which will provide valuable real-life data on the use LABA/LAMA FDCs in daily practice in patients with or without an exacerbation history.
Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2011. Available from: http://goldcopd.org/