在重症喘中使用生物药物后,口服皮质类固醇的大量减少:基于瑞士药房数据的分析
Pierre-Olivier Bridevaux1, Arnaud Bourdin2, Isabelle Peytremann-Bridevaux3
1Service de Pneumologie, Centre Hospitalier du Valais Romand, Valais, Switzerland; Service de Pneumologie, Hôpitaux Universitaires de Genève, Genève, Switzerland; Université de Genève, Genève, Switzerland.
Respiratory medicine
|August 23, 2025
概括
在瑞士的严重喘患者中,生物疗法显著减少了口服皮质类固醇 (OCS) 的使用. 大多数开始使用生物药物的患者能够减少或停止OCS,从而改善结果.
科学领域:
- 肺病学
- 药理学
- 现实世界中的证据
背景情况:
- 严重的喘 (SA) 与严重的发病率有关,其特征是频繁恶化和大量口服皮质类固醇 (OCS) 的使用.
- 在临床试验中,生物疗法在SA结果中显示出持续的改善.
- 在现实环境中了解OCS和生物趋势对于管理SA至关重要.
研究的目的:
- 在生物启动前和之后估计口服皮质类固醇 (OCS) 的使用情况.
- 分析瑞士SA患者生物使用的年度趋势.
- 评估生物制剂对实际SA群体的OCS减少的影响.
主要方法:
- 使用来自瑞士IQVIA LRx网络 (2018-2023) 的匿名药房索赔数据.
- 根据标准确定SA患者 (≥12岁),包括定期使用固定剂量组合,OCS或SA的生物药物.
- 主要测量结果是OCS后生物启动总年剂量 (TAD) 的变化.
主要成果:
- 在2023年,10.6%的可能喘患者 (n=3882) 被确定为SA (平均年龄为61,女性为57%).
- 亚麻风病的生物发病率从2018年的0.4%增加到2023年的14.3%.
- 在532个生物启动者中,53%使用了OCS;其中36%的OCS被断奶 (p<0.0001),持续使用OCS的患者的TAD减少了68.8% (p<0.0001).
结论:
- 严重的喘占瑞士喘人口的很大一部分,经常使用高剂量的OCS.
- 人们越来越多地采用生物疗法来治疗AS.
- 在SA患者中,开始使用生物药物会显著减少或停止使用OCS.
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