A simple rule to identify patients with chronic obstructive pulmonary disease who may need treatment reevaluation

Summary Background A simple rule based on short-acting inhaled β2 -agonist (SABA) use could identify patients with chronic obstructive pulmonary disease (COPD) at increased risk of exacerbations and signal the need for maintenance therapy change, similar to asthma “Rules of Two® ”. Methods Associations between SABA use, COPD exacerbations, and health care costs over 1 year were examined retrospectively using de-identified patient data from the Optum Research Database (ORD; N = 56,581) and the Impact National Benchmark Database (IMPACT™; N = 9423). Nebulized and metered-dose inhaler (MDI) SABA doses were normalized to 2.5 mg and 90 mcg albuterol equivalents, respectively. Results The GOLD initiative establishes ≥2 exacerbations/year as indicative of increased risk in COPD. We identified a correlation ( p