Clinical Characteristics and Treatment of Patients Diagnosed with Pulmonary Arterial Hypertension: A Real-World Study in the USA, Europe and Japan.

IF 3.4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Advances in Therapy Pub Date : 2024-11-04 DOI:10.1007/s12325-024-03026-1

C D Vizza, R Klok, J Harley, M Small, M Scott, D Lautsch, R J White

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Abstract

Introduction: This study aimed to describe the clinical characteristics of patients with pulmonary arterial hypertension, treatment received, and factors predicting initial or earlier combination therapy.

Methods: The Adelphi Real World Pulmonary Arterial Hypertension (PAH) Disease Specific Programme™ is a cross-sectional survey with retrospective data collection conducted in the USA, Europe (France, Germany, Italy, Spain, and the UK), and Japan from March to August 2022. Physicians reported patient characteristics, treatment history, and reasons for treatment selection. Descriptive statistics were grouped by country and World Health Organization functional classification. A multivariable Cox regression analysis investigated factors predicting initial or earlier combination therapy use.

Results: Data for 1173 patients was provided by 293 physicians. Patients' mean (standard deviation) age was 58.7 (13.8) years and 54.6% were female. Overall, 91.2% of patients were receiving, or had previously received, PAH-specific treatment. About three-quarters of the cohort were still taking the initial treatment strategy: for this group, 54% were prescribed monotherapy and 32% combination therapy; 15% of patients received supportive therapy alone. The proportion of patients receiving PAH-specific treatment was lowest in the USA (82.0%) and highest in France (94.6%). The proportion of patients receiving PAH on combination therapy was lowest in the USA (23.8%) and highest in Germany (36.5%). Treatment was prescribed for PAH in 87.6%, 89.8%, 89.3%, and 75.0% of patients who were functional class I, II, III, and IV, respectively, and combination therapy usage was more likely for those with more advanced functional class. Higher risk status, care by a pulmonologist, Japanese residence, more complete assessments, and hospitalization in the past 12 months were statistically associated with decreased time to combination therapy for PAH. Older age was statistically associated with increased time to combination therapy.

Conclusion: In this real-world, geographically diverse sample, monotherapy treatment was common, even among patients with advanced disease.

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肺动脉高压患者的临床特征和治疗：美国、欧洲和日本的真实世界研究。

简介：本研究旨在描述肺动脉高压患者的临床特征、接受的治疗以及预测初始或早期联合治疗的因素：本研究旨在描述肺动脉高压患者的临床特征、接受的治疗以及预测初始或早期联合治疗的因素：Adelphi Real World Pulmonary Arterial Hypertension (PAH) Disease Specific Programme™ 是一项回顾性数据收集的横断面调查，于 2022 年 3 月至 8 月在美国、欧洲（法国、德国、意大利、西班牙和英国）和日本进行。医生报告了患者特征、治疗史和选择治疗的原因。描述性统计按国家和世界卫生组织功能分类进行分组。一项多变量 Cox 回归分析调查了预测初次或更早使用联合疗法的因素：293名医生提供了1173名患者的数据。患者的平均年龄（标准差）为 58.7（13.8）岁，54.6% 为女性。总体而言，91.2%的患者正在接受或曾经接受过针对 PAH 的治疗。约四分之三的患者仍在接受最初的治疗策略：其中，54%的患者接受单一疗法，32%的患者接受综合疗法；15%的患者仅接受支持疗法。接受 PAH 专项治疗的患者比例在美国最低（82.0%），在法国最高（94.6%）。接受 PAH 综合治疗的患者比例在美国最低（23.8%），在德国最高（36.5%）。分别有 87.6%、89.8%、89.3% 和 75.0% 的功能分级为 I、II、III 和 IV 的患者接受了 PAH 治疗，功能分级越高的患者越有可能接受联合治疗。从统计学角度看，高风险状态、接受肺科医生的治疗、居住在日本、接受更全面的评估以及在过去 12 个月中住院治疗与减少 PAH 综合治疗的时间有关。年龄越大，接受综合治疗的时间越长：结论：在这一真实世界、地域多样的样本中，即使在晚期患者中，单一疗法也很常见。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.