日本哮喘患者开始接受糠酸氟替卡松/优甲乐/维兰特罗单吸入剂三联疗法的实际特点

IF 2.4 Q2 RESPIRATORY SYSTEM Respiratory investigation Pub Date : 2024-05-24 DOI:10.1016/j.resinv.2024.05.011
Toru Oga , Chifuku Mita , Risako Ito , Gema Requena , Kieran J. Rothnie , Stephen G. Noorduyn , Liza Yuanita , Masao Yarita
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引用次数: 0

摘要

背景在日本,评估开始吸入皮质类固醇/长效毒蕈碱拮抗剂/长效β2-受体激动剂(ICS/LAMA/LABA)三联疗法的哮喘患者特征的实际数据非常有限。方法对年龄≥15 岁新开始单次或多次吸入三联疗法(SITT:糠酸氟替卡松/优甲乐/维兰特罗 [FF/UMEC/VI],SITT:使用 JMDC/Medical Data Vision (MDV) 医疗保险数据库对 2021 年 2 月至 2022 年 2 月(首次处方日期:索引日期)期间的患者进行分组(SITT:糠酸氟替卡松/优甲乐/维兰特罗 [FF/UMEC/VI];SITT:茚达特罗/溴化甘草酸铵/糠酸甲米松 [IND/GLY/MF] 或 MITT)或 ICS/LABA。患者被分配到三个互不排斥的队列中:A)新的 FF/UMEC/VI 启动者;B)新的 FF/UMEC/VI、IND/GLY/MF 或 MITT 启动者;C)新的 FF/UMEC/VI、IND/GLY/MF、MITT 或 ICS/LABA 作为初始维持治疗 (IMT) 的启动者。结果队列 A:在新的 FF/UMEC/VI 启动者中,12.8% 和 0.1%(JMDC)和 21.7% 和 0.9%(MDV)的患者有≥1 次中度和重度病情加重;52.0%(JMDC)和 79.2%(MDV)使用 ICS/LABA。队列 B:与 MITT 相比,大多数患者开始使用 FF/UMEC/VI 和 IND/GLY/MF(JMDC:91.3% vs 8.7%;MDV:67.8% vs 32.2%),病情加重次数更少,使用的抢救药物也更少。队列 C:作为 IMT 的 FF/UMEC/VI 启动者与作为 IMT 的 ICS/LABA 启动者相比,有更大比例的患者在指数期出现中度病情加重(JMDC:17.8% vs 10.7%;MDV:8.0% vs 5.1%)。医生可能会在病情加重时开具三联疗法的处方,而不是作为 IMT 的双重疗法。
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Real-world characteristics of patients with asthma initiating fluticasone furoate/umeclidinium/vilanterol single-inhaler triple therapy in Japan

Background

Real-world data assessing characteristics of patients with asthma initiating inhaled corticosteroid/long-acting muscarinic antagonist/long-acting β2-agonist (ICS/LAMA/LABA) triple therapy in Japan are limited.

Methods

Descriptive, observational study of patients with asthma aged ≥15 years newly initiating single- or multiple-inhaler triple therapy (SITT: fluticasone furoate/umeclidinium/vilanterol [FF/UMEC/VI], SITT: indacaterol/glycopyrronium bromide/mometasone furoate [IND/GLY/MF] or MITT) or ICS/LABA using JMDC/Medical Data Vision (MDV) health insurance databases from February 2021–February 2022 (first prescription date: index date). Patients were assigned to three non-mutually exclusive cohorts: A) new FF/UMEC/VI initiators; B) new FF/UMEC/VI, IND/GLY/MF, or MITT initiators; C) new FF/UMEC/VI, IND/GLY/MF, MITT or ICS/LABA initiators as initial maintenance therapy (IMT). Patient characteristics were assessed descriptively for 12-months pre-treatment initiation (baseline period).

Results

Cohort A: among new FF/UMEC/VI initiators, 12.8% and 0.1% (JMDC) and 21.7% and 0.9% (MDV) of patients had ≥1 moderate and severe exacerbation; 52.0% (JMDC) and 79.2% (MDV) had ICS/LABA use. Cohort B: most patients initiated FF/UMEC/VI and IND/GLY/MF over MITT (JMDC: 91.3% vs 8.7%; MDV: 67.8% vs 32.2%), with fewer exacerbations and lower rescue medication use. Cohort C: a greater proportion of FF/UMEC/VI initiators as IMT experienced a moderate exacerbation at index versus ICS/LABA initiators as IMT (JMDC: 17.8% vs 10.7%; MDV: 8.0% vs 5.1%).

Conclusions

Patient characteristics were generally similar between treatment groups; SITT initiators had fewer exacerbations and lower rescue medication use than MITT initiators, represented by the greater proportion of IMT among SITT versus MITT initiators. Physicians may have prescribed triple over dual therapy as IMT in response to an exacerbation.

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来源期刊
Respiratory investigation
Respiratory investigation RESPIRATORY SYSTEM-
CiteScore
4.90
自引率
6.50%
发文量
114
审稿时长
64 days
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