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Table 5 Results from the joint frailty model, including selected covariates, when applied to the pooled datasets

From: Improving the evaluation of COPD exacerbation treatment effects by accounting for early treatment discontinuations: a post-hoc analysis of randomized clinical trials

 

Exacerbations (moderate/severe)

Early treatment discontinuations

Pooled A-C

HR (95% CI)

Pooled D-E

HR (95% CI)

Pooled A-C

HR (95% CI)

Pooled D-E

HR (95% CI)

Demographics

 Age (+ 1 year)

1.00 (0.99–1.00)

1.00 (0.99–1.00)

1.01 (1.00–1.02)

1.01 (1.00–1.03)

 Sex (male vs female)

  

1.29 (1.06–1.56)

1.24 (1.00–1.55)

Region

 Western Europe vs US

1.10 (0.91–1.34)

1.56 (1.28–1.90)

0.59 (0.43–0.82)

1.27 (0.86–1.87)

 Eastern Europe vs US

0.49 (0.42–0.57)

0.61 (0.52–0.71)

0.21 (0.16–0.28)

0.45 (0.34–0.61)

 Rest of the World vs US

0.83 (0.70–0.99)

0.83 (0.73–0.95)

0.30 (0.22–0.41)

0.50 (0.39–0.64)

Treatment

 BUD/FM 320 vs FM

0.71 (0.61–0.82)

 

0.73 (0.56–0.94)

 

 BUD/FM 160 vs FM

0.71 (0.61–0.83)

 

0.75 (0.59–0.97)

 

 BUD 320 + FM vs FM

0.57 (0.42–0.77)

 

0.58 (0.36–0.94)

 

 BUD 320 vs FM

0.77 (0.58–1.04)

 

1.03 (0.65–1.64)

 

 PBO vs FM

1.20 (1.00–1.44)

 

1.12 (0.84–1.50)

 

 SOC + RFL vs SOC

 

0.88 (0.80–0.97)

 

1.61 (1.34–1.94)

Disease related baseline factors

 Exacerbation history

 (+ 1 previous year)

1.16 (1.12–1.21)

1.21 (1.14–1.28)

  

 Smoking history

 (+ 10 pack-years)

1.02 (1.01–1.04)

   

 ICS history (yes vs no)

1.19 (1.06–1.34)

   

 Bronchodilator history

 (yes vs no)

1.30 (1.16–1.46)

   

 FEV1 (+ 100 mL)

0.92 (0.90–0.93)

0.52 (0.45–0.61)

0.7 (0.53–0.93)

0.551 (0.40–0.76)

 SGRQ total score (+ 10 points)

1.04 (1.00–1.09)

 

1.01 (1.00–1.02)

 

 Breathlessness (+ 1 point)

1.11 (1.02–1.21)

   

 CAT total score (+ 5 points)

 

1.09 (1.05–1.13)

 

1.02 (1.00–1.03)

 Use of rescue medication

 (+ 1 puff)

1.04 (1.03–1.06)

1.03 (1.02–1.04)

1.04 (1.01–1.06)

 

Seasonality

 Spring vs Autumn

0.76 (0.68–0.85)

1.00 (0.90–1.11)

  

 Summer vs Autumn

0.69 (0.61–0.77)

0.78 (0.70–0.87)

  

 Winter vs Autumn

1.07 (0.97–1.19)

1.17 (1.06–1.29)

  

Trial effect

 A vs C

0.76 (0.65–0.89)

 

0.86 (0.67–1.10)

 

 B vs C

0.85 (0.70–1.03)

 

0.78 (0.57–1.07)

 

 E vs D

 

1.08 (0.94–1.25)

 

1.64 (1.20–2.24)

 

Association parameters*

 

Pooled A-C

Pooled D-E

Frailty variance

1.14 (SE = 0.07)

0.67 (SE = 0.05)

Association (α)

1.54 (SE = 0.15)

0.95 (SE = 0.17)

  1. BUD budesonide, FM formoterol, RFL roflumilast, ICS inhaled corticosteroids, HR hazard ratio, CI confidence interval, SE standard error, US United States, * - all parameters significantly different from zero with p-value < 0.0001