PDF(Pubmed)
Abstract：
BACKGROUND: Adding LAMA to LABA/ICS is recommended to improve control in patients with persistent asthma.
METHODS: This observational, retrospective, before-and-after study considered patients diagnosed with asthma who started LABA/ICS + LAMA treatment (triple therapy, TT) between 1 January 2017 and 31 December 2018 and had been treated with LABA/ICS (dual therapy, DT) in the year before. Changes in lung function and exacerbation rates, healthcare resource utilization, and healthcare and non-healthcare costs (€2019) were estimated in patients with asthma in clinical practices in Spain. Data from computerized medical records from seven Spanish regions were collected ±1 year of LAMA addition.
RESULTS: 4740 patients (64.1 years old [SD: 16.3]) were included. TT reduced the incidence of exacerbations by 16.7% (p < 0.044) and the number of patients with exacerbations by 8.5% (p < 0.001) compared to previous DT. The rate of patients with severe exacerbations requiring systemic corticosteroids and their hospitalization rates significantly decreased by 22.5% and 29.5%. TT significantly improved FEV1, FVC, and FEV1/FVC, saving €571/patient for society. Younger patients with asthma (18-44 years old) and patients with severe asthma (FEV1 < 60%) performed better upon the initiation of TT.
CONCLUSIONS: TT reduced asthma exacerbations, improved lung function and reduced healthcare costs vs. DT, particularly in patients requiring systemic corticosteroids to treat severe exacerbations.
METHODS: This observational, retrospective, before-and-after study considered patients diagnosed with asthma who started LABA/ICS + LAMA treatment (triple therapy, TT) between 1 January 2017 and 31 December 2018 and had been treated with LABA/ICS (dual therapy, DT) in the year before. Changes in lung function and exacerbation rates, healthcare resource utilization, and healthcare and non-healthcare costs (€2019) were estimated in patients with asthma in clinical practices in Spain. Data from computerized medical records from seven Spanish regions were collected ±1 year of LAMA addition.
RESULTS: 4740 patients (64.1 years old [SD: 16.3]) were included. TT reduced the incidence of exacerbations by 16.7% (p < 0.044) and the number of patients with exacerbations by 8.5% (p < 0.001) compared to previous DT. The rate of patients with severe exacerbations requiring systemic corticosteroids and their hospitalization rates significantly decreased by 22.5% and 29.5%. TT significantly improved FEV1, FVC, and FEV1/FVC, saving €571/patient for society. Younger patients with asthma (18-44 years old) and patients with severe asthma (FEV1 < 60%) performed better upon the initiation of TT.
CONCLUSIONS: TT reduced asthma exacerbations, improved lung function and reduced healthcare costs vs. DT, particularly in patients requiring systemic corticosteroids to treat severe exacerbations.
摘要：
背景：建议在LABA/ICS中添加LAMA以改善持续性哮喘患者的控制。
方法：这种观察，回顾性,前后研究考虑了开始接受LABA/ICS+LAMA治疗的哮喘患者（三联疗法，TT），在2017年1月1日至2018年12月31日期间接受过LABA/ICS治疗（双重治疗，DT）在前一年。肺功能和恶化率的变化，医疗保健资源利用，对西班牙临床实践中哮喘患者的医疗保健和非医疗保健费用(2019欧元)进行了估计。从LAMA添加±1年的时间收集了来自西班牙七个地区的计算机化病历数据。
结果：纳入4740例患者（64.1岁[SD：16.3]）。与以前的DT相比，TT使加重的发生率降低了16.7％（p<0.044），加重的患者人数降低了8.5％（p<0.001）。需要全身性糖皮质激素的严重加重患者的发生率及其住院率显着下降了22.5％和29.5％。TT显著改善FEV1、FVC、和FEV1/FVC，为社会节省571欧元/患者。年轻的哮喘患者（18-44岁）和重度哮喘患者（FEV1<60％）在TT开始后表现更好。
结论：TT减少哮喘加重，改善肺功能和降低医疗成本vs.DT,特别是在需要全身性皮质类固醇治疗严重加重的患者中。
方法：这种观察，回顾性,前后研究考虑了开始接受LABA/ICS+LAMA治疗的哮喘患者（三联疗法，TT），在2017年1月1日至2018年12月31日期间接受过LABA/ICS治疗（双重治疗，DT）在前一年。肺功能和恶化率的变化，医疗保健资源利用，对西班牙临床实践中哮喘患者的医疗保健和非医疗保健费用(2019欧元)进行了估计。从LAMA添加±1年的时间收集了来自西班牙七个地区的计算机化病历数据。
结果：纳入4740例患者（64.1岁[SD：16.3]）。与以前的DT相比，TT使加重的发生率降低了16.7％（p<0.044），加重的患者人数降低了8.5％（p<0.001）。需要全身性糖皮质激素的严重加重患者的发生率及其住院率显着下降了22.5％和29.5％。TT显著改善FEV1、FVC、和FEV1/FVC，为社会节省571欧元/患者。年轻的哮喘患者（18-44岁）和重度哮喘患者（FEV1<60％）在TT开始后表现更好。
结论：TT减少哮喘加重，改善肺功能和降低医疗成本vs.DT,特别是在需要全身性皮质类固醇治疗严重加重的患者中。
