确定使用吸入糖皮质激素/长效β-2-肾上腺素能激动剂(ICS/LABA)的固定剂量组合开始吸入治疗哮喘的患者的治疗持久性和恶化。
回顾电子病历(数据库:FundaciónRediSS)进行的回顾性观察性研究。
回顾性队列研究。随访期为1年。
本研究纳入年龄≥18岁、开始接受ICS/LABA治疗且符合纳入/排除标准的患者。
研究组为丙酸氟替卡松/沙美特罗(FP/SAL),倍氯米松/福莫特罗(BDP/FORM),布地奈德/福莫特罗(BUD/FORM),糠酸氟替卡松/维兰特罗(FF/VI)和丙酸氟替卡松/福莫特罗(FP/FORM)。主要的测量是持久性,药物占有比(MPR)和恶化。统计学显著性确定为p<0.05。
总共,招募了3203名患者进行研究。按团体,31.1%FP/SAL,28.6%BDP/FORM,25.0%芽/形态,8.2%FF/VI和7.0%FP/FORM。平均年龄为52.2岁,60.8%为女性,44.9%为持续中度哮喘。治疗持久性为61.7%(95%CI为60.0%至63.4%),研究组为FP/SAL:60.7%,BDP/FORM:61.2%,芽/形式:60.3%,FF/VI:66.7%,FP/FORM:67.6%(p=0.046)。研究组的MPR为FP/SAL:74.3%,BDP/FORM:73.8%,BUD/FORM:74.6%,FF/VI:79.4%,FP/FORM:80.6%(p=0.028)。死亡率为2.9%。按治疗组,加重为FP/SAL:21.9%(95%CI19.3%至24.5%),BDP/FORM:22.2%(95%CI19.5%至24.9%),BUD/FORM:22.8%(95%CI19.9%至25.7%),FF/VI:17.9%(95%CI14.9%至20.7%)和FP/FORM:16.0%(95%CI12.2%至19.3%),p=0.036。
接受FP/FORM和FF/VI与FP/SAL治疗的患者,BDP/FORM和BUD/FORM与更高的治疗依从性相关(持久性,MPR)和较低的恶化率。然而,需要进一步研究以加强结果的一致性。
To determine treatment persistence and exacerbations in patients initiating inhaler treatment with fixed-dose combinations of inhaled corticosteroids/long-acting beta-2-adrenergic agonists (ICS/LABA) for the treatment of asthma.
Retrospective observational study conducted by review of electronic medical records (database: Fundación RediSS).
Retrospective cohort
study. The follow-up period was 1 year.
The
study included patients aged ≥18 years who started treatment with ICS/LABA and met the inclusion/exclusion criteria.
The
study groups were fluticasone propionate/salmeterol (FP/SAL), beclomethasone/formoterol (BDP/FORM), budesonide/formoterol (BUD/FORM), fluticasone furoate/vilanterol (FF/VI) and fluticasone propionate/formoterol (FP/FORM). The main measurements were persistence, medication possession ratio (MPR) and exacerbations. Statistical significance was established as p<0.05.
In total, 3203 patients were recruited for the
study. By groups, 31.1% FP/SAL, 28.6% BDP/FORM, 25.0% BUD/FORM, 8.2% FF/VI and 7.0% FP/FORM. The mean age was 52.2 years, 60.8% were female and 44.9% had persistent-moderate asthma. Treatment persistence was 61.7% (95% CI 60.0% to 63.4%) and by
study group it was FP/SAL: 60.7%, BDP/FORM: 61.2%, BUD/FORM: 60.3%, FF/VI: 66.7% and FP/FORM: 67.6% (p=0.046). MPR by study group was FP/SAL: 74.3%, BDP/FORM: 73.8%, BUD/FORM: 74.6%, FF/VI: 79.4% and FP/FORM: 80.6% (p=0.028). The mortality rate was 2.9%. By treatment group, exacerbations were FP/SAL: 21.9% (95% CI 19.3% to 24.5%), BDP/FORM: 22.2% (95% CI 19.5% to 24.9%), BUD/FORM: 22.8% (95% CI 19.9% to 25.7%), FF/VI: 17.9% (95% CI 14.9% to 20.7%) and FP/FORM: 16.0% (95% CI 12.2% to 19.3%), p=0.036.
Patients undergoing treatment with FP/FORM and FF/VI versus FP/SAL, BDP/FORM and BUD/FORM were associated with greater treatment adherence (persistence, MPR) and lower rates of exacerbations. However, further studies will be needed to strengthen the consistency of the results.