法国COPD患者处方的单次和多次吸入器三重治疗的使用和持久性:在THIN数据库 (OPTI研究) 上的一项回顾性研究
Gaétan Deslee1, Caroline Fabry-Vendrand2, Nolwenn Poccardi3
1Service de Pneumologie, INSERM UMRS-1250, CHU de Reims, Université Reims Champagne-Ardenne, CHU de Reims, Reims, France.
BMJ open respiratory research
|June 1, 2023
概括
单次吸入器三重疗法 (SITT) 与多次吸入器三重疗法 (MITT) 相比,慢性阻塞性肺病 (COPD) 患者的持续性得到改善. 这项在法国的现实研究强调了SITT作为一种可能更有效的治疗选择.
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.
- 现实世界的证据.
背景情况:
- 针对中度至重度慢性阻塞性肺病 (COPD) 的单个吸入器三重疗法 (SITT) 在2018年在法国开始使用.
- 与多个吸入器三重疗法 (MITT) 相比,SITT提供了简化吸入器使用,潜在地改善了坚持和持久性.
- 有限的现实世界数据存在于SITT与MITT的比较有效性.
研究的目的:
- 评估法国MITT和SITT的使用情况.
- 在现实环境中比较SITT和MITT之间的治疗持久性.
- 评估与SITT与MITT开始相关的患者特征.
主要方法:
- 使用法国健康改善网络 (THIN) 数据库进行的回顾性队列研究.
- 包括COPD患者在2017年7月至2019年12月期间开始三重治疗的患者.
- 治疗中断定义为治疗中的60天间隔,以评估持续性.
主要成果:
- 3134名患者开始了三重疗法; 485人使用SITT. 2019年,SITT的使用率达到28.2%.
- 开始SITT的患者更有可能接受肺病学家的治疗,并且患有并发性喘的患病率更高.
- 中位持续时间为SITT的181天,而MITT的135天. 一年持久性为SITT的33%,而MITT的18% (调整HR为1.47,p<0.001).
结论:
- 与MITT相比,SITT在法国COPD患者中表现出明显更高的持续性.
- 大多数开始三重治疗的患者先前接受过双重治疗,并且有恶化的病史.
- 在COPD管理中,SITT代表了一种有价值的治疗选择,可以提高治疗坚持度.
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