ICS/LABA联合应用于现实生活中的哮喘临床控制

Q4 Health Professions Klinicka Farmakologie a Farmacie Pub Date : 2019-10-28 DOI:10.36290/FAR.2019.017
Š. Laššán, Ildikó Téglás, M. Laššánová
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引用次数: 1

摘要

在随机对照试验中,长期作用β2-肾上腺素受体激动剂(LABA)和吸入皮质类固醇(ICS)的固定组合进行常规治疗可控制哮喘。在现实生活中是否有可能达到类似的结果?方法:在一项为期3个月的多中心前瞻性研究中,不符合哮喘完全控制标准的患者在医生指导下使用ICS/LABA固定组合治疗3个月。教育患者正确的吸入器技术和坚持治疗的重要性。结果:纳入494例患者,平均年龄39.0 (SD 16.2)岁,病程6.3年(SD 7.5)。在治疗阶段,观察到白天症状(从93%降至23%,p < 0.001)和夜间症状(从81%降至10%,p < 0.001)的患者显著减少。哮喘控制测试平均评分由16.7分(SD 3.8)逐渐升高至23.8分(SD 1.7) (p < 0.001)。未控制哮喘患者的比例从基线访问时的76%下降到研究期结束时的2% (p < 0.001)。ICS的平均剂量从基线721 (SD 289) μg / d降至最终672 (SD 317) μg / d (p = 0.041)。多因素分析(logistic回归)显示,年龄≥40岁(OR = 0.552, p = 0.002)和吸烟(OR = 0.527, p = 0.026)显著降低哮喘控制率。结论:在现实生活中,定期使用ICS/LABA治疗和改善依从性/吸入器处理可在短短三个月内显著增加哮喘控制。
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Targeting asthma control in real‑life clinical practice by using ICS/LABA combination
Introduction: Regular treatment with a fixed combination of long‑acting β2-adrenoreceptor agonist (LABA) and inhaled corticosteroid (ICS) led to asthma control in randomized controlled trials. Is it possible to reach similar results in a real‑life setting? Methods: During a 3-month multicenter prospective study, patients not meeting the criteria of total asthma control were treated for three months with a fixed combination of ICS/LABA guided by a physician. The patients were educated in proper inhaler technique and importance of adherence to treatment. Results: Four hundred and ninety‑four patients were included with a mean age of 39.0 (SD 16.2) years and disease duration of 6.3 years (SD 7.5). During the treatment phase, a significant reduction in patients with day‑time (from 93% to 23%, p < 0.001) and night‑time symptoms (from 81% to 10%, p < 0.001) was observed. The mean Asthma Control Test score gradually increased from 16.7 (SD 3.8) to 23.8 (SD 1.7) (p < 0.001). The proportion of uncontrolled asthma patients decreased from 76% at the baseline visit to 2% at the end of the study period (p < 0.001). The mean dose of ICS decreased from the baseline 721 (SD 289) μg to the final 672 (SD 317) μg (p = 0.041) daily. According to multivariate analysis (logistic regression), an age ≥ 40 years (OR = 0.552, p = 0.002) and smoking (OR = 0.527, p = 0.026) significantly decreased asthma control. Conclusion: In a real‑life scenario, regular treatment with ICS/LABA and improved adherence/inhaler handling resulted in a significant increase in asthma control in as little as three months.
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来源期刊
Klinicka Farmakologie a Farmacie
Klinicka Farmakologie a Farmacie Health Professions-Pharmacy
CiteScore
0.30
自引率
0.00%
发文量
20
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