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Article History

Received: 28 June 2024

Accepted: 4 October 2024

First Online: 19 November 2024

Declarations

:

: Gary Tse, Cono Ariti, and Jiandong Zhou are former employees of the Observational and Pragmatic Research Institute (OPRI), which was funded by AstraZeneca to conduct this study. Gary Tse is a current employee of Hong Kong Metropolitan University (Hong Kong SAR, China). Cono Ariti is a current employee of Oxon Epidemiology (Madrid, Spain). Jiandong Zhou is a current employee of the Department of Family Medicine and Primary Care at the University of Hong Kong (Hong Kong SAR, China). Victoria Carter and Derek Skinner are employees of OPRI, which was funded by AstraZeneca to conduct this study. Mona Bafadhel has received research grants to her institution from AstraZeneca; honoraria to her institution from AstraZeneca, Chiesi, and GlaxoSmithKline; and is an advisory board member for Albus Health and ProAxsis. Alberto Papi has received scientific grants to his institution from Agenzia Italiana del Farmaco, AstraZeneca, Chiesi, GlaxoSmithKline, and Sanofi; has received consulting fees from AstraZeneca, Avillion, Chiesi, ELPEN Pharmaceuticals, GlaxoSmithKline, Novartis, and Sanofi; has received payment or honoraria for lectures, presentations, speaker bureaus, or educational events from AstraZeneca, Avillion, Chiesi, Edmond Pharma, ELPEN Pharmaceuticals, GlaxoSmithKline, IQVIA, Menarini, Mundipharma, Novartis, Sanofi, and Zambon; and is an advisory board member for AstraZeneca, Avillion, Chiesi, ELPEN Pharmaceuticals, GlaxoSmithKline, IQVIA, MSD, Novartis, and Sanofi. Xiao Xu, Hana Müllerová, and Benjamin Emmanuel are employees of AstraZeneca and hold stock and/or stock options in the company. David Price is an employee of OPRI, which was funded by AstraZeneca to conduct this study; has advisory board memberships with AstraZeneca, Boehringer Ingelheim, Chiesi, Mylan, Novartis, Regeneron Pharmaceuticals, Sanofi Genzyme, and Thermofisher; has consultancy agreements with Airway Vista Secretariat, AstraZeneca, Boehringer Ingelheim, Chiesi, EPG Communication Holdings Ltd, FIECON Ltd, Fieldwork International, GlaxoSmithKline, Mundipharma, Mylan, Novartis, OM Pharma SA, PeerVoice, Phadia AB, Spirosure Inc, Strategic North Limited, Synapse Research Management Partners S.L., Talos Health Solutions, Theravance, and WebMD Global LLC; has received grants and unrestricted funding for investigator-initiated studies (conducted through OPRI) from AstraZeneca, Boehringer Ingelheim, Chiesi, Mylan, Novartis, Regeneron Pharmaceuticals, Respiratory Effectiveness Group, Sanofi Genzyme, Theravance, and UK NHS; has received payment for lectures/speaking engagements from AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, GlaxoSmithKline, Kyorin, Mundipharma, Mylan, Novartis, Regeneron Pharmaceuticals, and Sanofi Genzyme; has received payment for travel/accommodation/meeting expenses from AstraZeneca, Boehringer Ingelheim, Mundipharma, Mylan, Novartis, and Thermofisher; has stock/stock options from AKL Research and Development Ltd, which produces phytopharmaceuticals; owns 74% of the social enterprise Optimum Patient Care Ltd (Australia and UK) and 92.61% of OPRI (Singapore); has a 5% shareholding in Timestamp, which develops adherence monitoring technology; is peer reviewer for grant committees of the UK Efficacy and Mechanism Evaluation Programme and Health Technology Assessment; and has been an expert witness for GlaxoSmithKline. David Price is an Editorial Board member of Advances in Therapy. David Price was not involved in the selection of peer reviewers for the manuscript nor any of the subsequent editorial decisions.

: This study used anonymized deidentified data and, as such, patient consent and relevant ethics approvals were not required. However, scientific and ethics review were sought through appropriate channels. Per best practice research standards for observational research and in compliance with the NHS Health Research Authority Research Ethics Committee (REC reference 21/EM/0265 []) for deidentified data held by the CPRD, which includes approval for the governance processes that must be followed for individual studies using CPRD data, the protocol of this study was approved by the CPRD Independent Scientific Advisory Committee (reference number 20_159R) and was registered with the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (EUPAS35975). No patient-identifying information was accessible during the study.