Temporal trends in pulmonary arterial hypertension: results from the COMPERA registry.
Temporal trends in pulmonary arterial hypertension: results from the COMPERA registry.
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DOI：
10.1183/13993003.02024-2021
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发表时间：
2022-06
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--
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自2015年起，欧洲肺动脉高压指南建议大多数肺动脉高压（PAH）患者使用联合治疗。然而，尚不清楚这种治疗策略在临床实践中的采用程度以及它是否与改善长期生存相关。我们分析了来自欧洲大型肺动脉高压登记处 COMPERA 的数据，以评估 2010 年至 2019 年间联合治疗的使用和新诊断 PAH 患者的生存率的时间趋势。对于生存分析，我们查看了年化数据以及比较 2010-2014 年和 2015-2019 年期间的累积数据。总共纳入 2531 名患者。早期（诊断后3个月内）联合治疗的使用率从2010年诊断为PAH的患者的10.0%增加到2019年诊断为PAH的患者的25.0%。诊断后1年接受联合治疗的患者比例从27.7%增加到46.3%。比较 2010-2014 年和 2015-2019 年期间，1 年生存率估计相似（分别为 89.0%（95% CI 87.2-90.9%）和 90.8%（95% CI 89.3-92.4%）），而 3 年生存率估计值略有但不显着改善（67.8%（95% CI）分别为 65.0–70.8%) 和 70.5% (95% CI 67.8–73.4%)。 2010年至2019年，联合疗法的使用有所增加，但大多数患者仍接受单一疗法。诊断后 1 年的生存率没有随时间变化。未来的研究需要确定观察到的表明 3 年生存率提高的趋势是否可以得到证实。在对 2010 年至 2019 年 PAH 治疗模式和生存率时间趋势的分析中，本研究发现靶向联合疗法的使用有所增加，但诊断后 3 年的生存率只有轻微、不显着的改善趋势 https://bit.ly/3FExlK5
Since 2015, the European pulmonary hypertension guidelines recommend the use of combination therapy in most patients with pulmonary arterial hypertension (PAH). However, it is unclear to what extent this treatment strategy is adopted in clinical practice and if it is associated with improved long-term survival. We analysed data from COMPERA, a large European pulmonary hypertension registry, to assess temporal trends in the use of combination therapy and survival of patients with newly diagnosed PAH between 2010 and 2019. For survival analyses, we looked at annualised data and at cumulated data comparing the periods 2010–2014 and 2015–2019. A total of 2531 patients were included. The use of early combination therapy (within 3 months after diagnosis) increased from 10.0% in patients diagnosed with PAH in 2010 to 25.0% in patients diagnosed with PAH in 2019. The proportion of patients receiving combination therapy 1 year after diagnosis increased from 27.7% to 46.3%. When comparing the 2010–2014 and 2015–2019 periods, 1-year survival estimates were similar (89.0% (95% CI 87.2–90.9%) and 90.8% (95% CI 89.3–92.4%), respectively), whereas there was a slight but nonsignificant improvement in 3-year survival estimates (67.8% (95% CI 65.0–70.8%) and 70.5% (95% CI 67.8–73.4%), respectively). The use of combination therapy increased from 2010 to 2019, but most patients still received monotherapy. Survival rates at 1 year after diagnosis did not change over time. Future studies need to determine if the observed trend suggesting improved 3-year survival rates can be confirmed. In this analysis of temporal trends in PAH treatment patterns and survival in 2010–2019, this study found an increase in the use of targeted combination therapies but only a slight, nonsignificant trend towards improved survival 3 years after diagnosis https://bit.ly/3FExlK5
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