在停止LAMA或ICS治疗后3个月内,COPD恶化风险的不成比例增加:来自FLAME试验的见解
Alexander G Mathioudakis1,2, Sebastian Bate3,4, Victoria Chatzimavridou-Grigoriadou5
1Division of Immunology, Immunity to Infection and Respiratory Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK alexander.mathioudakis@manchester.ac.uk.
在COPD患者中停止使用长效肌抗体 (LAMA) 或吸入性皮质类固醇 (ICS) 可能会增加恶化风险. 这项研究强调了LAMA和ICS的强烈戒断效应,强调了治疗坚持.
科学领域:
- 肺部病理学 肺部病理学
- 临床试验 临床试验
- 药理学 药理学是指药理学的学科.
背景情况:
- 慢性阻塞性肺病 (COPD) 护理的不良坚持往往导致治疗中止.
- 虽然已知吸入性皮质类固醇 (ICS) 的戒断会增加恶化风险,但长效肌抗体 (LAMA) 的戒断证据有限.
研究的目的:
- 在中度至重度COPD患者中研究LAMA和ICS的潜在戒断效应.
- 为了比较停止LAMA或ICS后的恶化率.
主要方法:
- 在3362名COPD患者中,对一项为期52周的试验进行了后期分析,将LABA+LAMA与LABA+ICS进行比较.
- 在停药后的第一季度评估每月恶化发病率.
- 使用多变量混合效应模型来分析恶化率的差异.
主要成果:
- 停止治疗的LAMA显示,中度至重度恶化 (病率比率高达2.2) 显著,暂时增加.
- 终止ICS与严重恶化严重的早期增加有关.
- ICS的戒断效应与基线血中乙氨基酸细胞计数不相关.
结论:
- 观察到强烈的LAMA和ICS治疗中止对COPD恶化的影响.
- 强调在临床试验设计中坚持治疗和考虑戒断效应的重要性.
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