严重哮喘:生物制剂可改善临床控制

A. Gülsen
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摘要

背景:哮喘是一种慢性气道疾病,影响着全球 3 亿多人。5%-10%的患者患有重症哮喘,占哮喘相关经济负担的 50%。有关重症哮喘临床病程的真实数据不足。研究目的本研究旨在了解瑞士重症哮喘登记处(SSAR)登记的瑞士重症哮喘患者的特征,并评估哮喘控制的预测因素。研究方法:对截至 2022 年 1 月登记在册的 278 名患者的特征进行了描述性分析。对社会人口学变量、合并症、诊断价值、哮喘治疗和医疗利用率进行了评估。根据哮喘控制测试结果,对哮喘得到控制和未得到控制的两组患者进行了比较。结果显示48%的患者为女性,平均年龄为 55.8 岁(13-87 岁不等)。平均体重指数(BMI)为 27.4 kg/m2(±6)。10.8%的患者目前吸烟。54.3%的患者有过敏合并症,其次是慢性鼻炎(46.4%)和鼻息肉(34.1%)。根据 ACT 评分,54.7% 的哮喘患者病情得到良好控制,16.2% 的患者病情得到部分控制,25.9% 的患者病情未得到控制。最常见的吸入疗法是联合吸入皮质类固醇/长效β2-激动剂(78.8%)。81.7%的患者使用生物制剂,19.1%的患者使用口服类固醇。多变量分析表明,生物制剂治疗与哮喘控制率呈正相关,而较高的体重指数、口服类固醇、病情加重和慢性阻塞性肺病则是哮喘控制率的负预测因素。
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Schweres Asthma: Biologika verbessern die klinische Kontrolle
Background: Asthma is a chronic airway disease, affecting over 300 million people worldwide. 5–10% of patients suffer from severe asthma and account for 50% of asthma-related financial burden. Availability of real-life data about the clinical course of severe asthma is insufficient. Objectives: The aims of this study were to characterize patients with severe asthma in Switzerland, enrolled in the Swiss Severe Asthma Registry (SSAR), and evaluate predictors for asthma control. Method: A descriptive characterisation of 278 patients was performed, who were prospectively enrolled in the registry until January 2022. Socio-demographic variables, comorbidities, diagnostic values, asthma treatment, and healthcare utilisation were evaluated. Groups of controlled and uncontrolled asthma according to the asthma control test were compared. Results: Forty-eight percent of patients were female and the mean age was 55.8 years (range 13–87). The mean body mass index (BMI) was 27.4 kg/m2 (±6). 10.8% of patients were current smokers. Allergic comorbidities occurred in 54.3% of patients, followed by chronic rhinosinusitis (46.4%) and nasal polyps (34.1%). According to the ACT score, 54.7% had well controlled, 16.2% partly controlled and 25.9% uncontrolled asthma. The most common inhalation therapy was combined inhaled corticosteroids/long-acting β2-agonists (78.8%). Biologics were administered to 81.7% of patients and 19.1% received oral steroids. The multivariable analysis indicated that treatment with biologics was positively associated with asthma control whereas higher BMI, oral steroids, exacerbations, and COPD were negative predictors for asthma control.
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