肺炎风险增加与COPD中的ICS之间的关联:从IMPACT研究中对患者因素的连续变量分析
Bhumika Aggarwal1, Paul Jones2, Alejandro Casas3
1Emerging Markets, GSK, 23 Rochester Park, Singapore, 139234, Singapore. bhumika.x.aggarwal@gsk.com.
吸入性皮质类固醇 (ICS) 治疗COPD的三重疗法显示,老年患者的肺炎风险增加,但患者的BMI和血中乙氨基酸细胞计数等因素在含有ICS和非ICS治疗之间没有显著改变这种风险.
科学领域:
- 肺部病理学 肺部病理学
- 临床试验 临床试验
- 呼吸系统医学 呼吸系统医学
背景情况:
- 含有吸入性皮质类固醇 (ICS) 的三重疗法在慢性阻塞性肺病 (COPD) 中提供了经过证明的好处.
- 临床医生经常限制ICS暴露,因为担心肺炎风险.
- 患者特定的因素也会导致COPD患者的肺炎风险.
研究的目的:
- 在COPD中将与ICS相关的肺炎风险置于背景.
- 为了评估影响COPD患者在ICS含治疗中的肺炎风险的患者相关因素.
- 根据患者特征,根据ICS含有和非ICS治疗方法之间的肺炎风险进行比较.
主要方法:
- 对52周的双盲IMPACT试验数据进行后期分析.
- 患有症状性慢性肺炎且在前一年至少出现过一次恶化的患者被随机分配到FF/UMEC/VI,FF/VI或UMEC/VI.
- 评估了与年龄,BMI,FEV1和血液中异氨基酸细胞数 (BEC) 相关的治疗期肺炎的年率.
主要成果:
- 肺炎风险在50岁左右是最低的,并且在63岁以上的患者中,ICS含有的治疗显著增加.
- 较低的BMI (<22.5 kg/m2) 与ICS和非ICS组的肺炎风险增加有关,没有差异效应.
- 与非ICS治疗相比,含有ICS的治疗表明与BEC相关的肺炎风险增加的门较高.
结论:
- 很少有证据表明,年龄,BMI,FEV1或BEC对含有ICS和非ICS治疗之间的肺炎率的影响有所不同.
- 这些发现强调了在为COPD处方含有ICS的治疗方法时需要进行均衡的风险效益评估的必要性.
- 个体患者的因素可能不会显著改变COPD中ICS观察到的不同肺炎风险.
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