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在患有慢性阻塞性肺病的患者中,LABA/LAMA FDC与LABA/ICS FDC的心血管安全性比较:以目标试验仿真框架为基础的基于人口的队列研究

Chun-Yu Chen^1,2, Sheng-Wei Pan^3,4, Chia-Chen Hsu^2,5

¹Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Respiratory research

|September 29, 2023

概括

长效β2激动剂/长效肌肉抗剂 (LABA/LAMA) 固定剂量组合 (FDCs) 在COPD患者中显示与LABA/吸入性皮质类固醇 (ICS) FDCs相比较的心血管安全性. 这项研究发现LABA/LAMA FDC与LABA/ICS FDC相比没有增加心血管风险.

科学领域:

肺部医学肺部医学
心脏病学心脏病学
药理学药理学是指药理学的学科.

背景情况:

长效β2激动剂/长效肌抗体 (LABA/LAMA) 的使用在COPD中越来越多.
关于LABA/LAMA与LABA/吸入性皮质类固醇 (ICS) 的心血管风险的有限且相互矛盾的证据.

研究的目的:

在COPD患者中比较LABA/LAMA和LABA/ICS固定剂量组合 (FDC) 的心血管安全性.
使用目标试验仿真框架进行强大的比较分析.

主要方法:

使用台湾全国数据库 (2017-2020) 进行的队列研究.
确定了启动LABA/LAMA FDC或LABA/ICS FDC的患者.
倾向性得分匹配和考克斯回归分析复合心血管事件 (MI,不稳定的心痛,心力衰竭,心律失常,缺血性中风).

主要成果:

在LABA/LAMA FDC和LABA/ICS FDC之间心血管风险没有显著差异 (HR 0.89;95% CI,0.78-1.01).
个人事件分析显示,复合事件,急性心肌梗塞,充血性心力衰竭,心律失常或缺血性中风的风险没有增加.
结果在敏感度和子组分析中保持一致.

结论:

在COPD患者中,LABA/LAMA FDC治疗与LABA/ICS FDC的心血管安全性相比较.
这些发现为LABA/LAMA FDCs的心血管安全概况提供了保证.

关键词:

心血管事件的发生.慢性阻塞性肺病是一种慢性阻塞性肺病.群组研究是一项群组研究.固定剂量组合 (FDC) 是指固定剂量的组合.长效β2激动剂/吸入性皮质类固醇 (LABA/ICS)长效β2激动剂/长效肌抗体 (LABA/LAMA) 的使用目标试验模拟框架目标试验模拟框架

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