EVELUT®:一项真实世界的观察性研究,评估COPD患者的呼吸不良和症状负担,从LABA/ICS转换到LAMA/LABA或LAMA/LABA/ICS
Roland Buhl1, Michael Dreher2, Muriel Mattiucci-Guehlke3
1Pulmonary Department, Mainz University Hospital, Langenbeckstrasse 1, 55131, Mainz, Germany. roland.buhl@gmail.com.
从长效β2-激动剂 (LABA) /吸入性皮质类固醇 (ICS) 转换为长效肌抗体 (LAMA) /LABA,与三重疗法相比,对于COPD患者提供类似的症状缓解. 这一策略符合GOLD 2023指南,避免不必要的ICS暴露.
科学领域:
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 全球慢性阻塞性肺病倡议 (GOLD) 2023年指导方针建议在症状性COPD中使用LABA/ICS的替代方案.
- 现在建议使用长效肌抗剂 (LAMA) /LABA,而不是三重疗法 (TT;LAMA/LABA/ICS),用于LABA/ICS治疗的患者,症状持续但恶化风险低.
研究的目的:
- 为了比较从LABA/ICS切换到LAMA/LABA的疗效,而不是在具有较低恶化风险的有症状的COPD患者中升级到TT.
- 评估这些患者群体的症状缓解和健康状况改善.
主要方法:
- EVELUT研究是一项观察性,现实世界的研究,包括有症状的COPD患者 (GOLD B).
- 患者从LABA/ICS转换为固定剂量的托/托 (Tio/Olo) 或TT.
- 主要终点包括12周修改后医学研究委员会 (mMRC) 和COPD评估测试 (CAT) 评分的变化.
主要成果:
- 在倾向性得分匹配分析中,Tio/Olo和TT组在mMRC得分中表现出类似的改善.
- 与TT组相比,Tio/Olo组在CAT分数中表现出略有更大的改善.
- 医生全球评估分数在两组中都有所改善,患者满意度高;Tio/Olo显示治疗响应率略高.
结论:
- 从LABA/ICS转换为LAMA/LABA的症状性COPD患者 (恶化风险低) 的临床益处与升级到LAMA/LABA/ICS的临床益处相当.
- 这种切换提供了一种有效的方式来管理症状和改善健康状况,同时可能减少ICS相关的风险.
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