严重喘中的真实世界生物使用模式,2015-2021年:CLEAR研究
Trung N Tran1, Stephanie Chen1, Benjamin Emmanuel1
1Respiratory and Immunology, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA.
Pragmatic and observational research
|March 24, 2025
概括
切换或停止严重喘的生物治疗与更糟糕的结果有关. 与改变或停止治疗相比,继续初始生物治疗与更好的临床结果和更少的恶化有关.
科学领域:
- 肺部病理学 肺部病理学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 针对免疫球蛋白E,白内素 (IL) - 4/IL-13,或IL-5通路的生物药物用于严重的喘.
- 低于最佳的患者反应可能会导致治疗修改,需要对现实世界的数据进行分析.
研究的目的:
- 评估严重喘患者生物使用的现实世界模式.
- 评估与继续,切换或停止生物治疗相关的临床结果.
主要方法:
- 一项多中心的观察性研究 (CLEAR) 涉及来自国际严重喘登记处的23个国家的1859名成年人.
- 患者根据他们的生物治疗轨迹 (继续,切换,停止) 在开始6个月内被分类.
- 结果在12个月后使用倾向分数加权的多变量回归模型来评估结果.
主要成果:
- 60.0%的人继续使用,25.5%的人转换,14.5%的人停止生物治疗.
- 切换或停止与更高的年度喘恶化率和不受控制的喘有关.
- 与继续治疗的患者相比,切换患者的口服皮质类固醇使用,住院和急诊室访问量增加.
结论:
- 在严重喘中切换或停止生物治疗与较差的临床结果有关.
- 持续的初始生物治疗似乎与更有利的长期结果有关.
相关概念视频
Asthma: Pathogenesis and Management
Asthma is a chronic pulmonary condition involving inflammation of the airways, hyper-reactivity, and reversible obstruction of the airways. This condition can significantly impact a person's quality of life, making breathing difficult and leading to distressing symptoms.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
Antiasthma Drugs: Leukotriene Modifiers
Leukotriene modifiers, or cysteinyl leukotriene receptor antagonists, are medications used to manage chronic asthma. These agents target specific inflammatory mediators produced during arachidonic acid metabolism, an essential process in generating inflammation in the body.
Leukotriene modifiers work through two distinct mechanisms:
Leukotriene modifiers work through two distinct mechanisms:
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
COPD: Management Using Bronchodilators and Corticosteroids
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
Asthma-II: Pathophysiology and Classification
Asthma is a prevalent chronic respiratory condition marked by inflammation and hyperresponsiveness of the airways. Its pathophysiology involves complex interactions among inflammatory pathways, immune responses, and neural mechanisms.
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
Asthma III: Clinical Manifestations
Asthma presents with a characteristic pattern of episodic respiratory symptoms that reflect underlying airway inflammation, bronchoconstriction, and mucus hypersecretion. Although severity varies among individuals, certain clinical manifestations are considered hallmarks of the disorder and often guide diagnosis and assessment.Respiratory SymptomsA persistent cough is one of the most common early features of asthma. It is frequently dry and tends to worsen at night or in the early morning,...


