Demographics, Treatment Patterns, and Morbidity in Patients with Exercise-Induced Bronchoconstriction: An Administrative Claims Data Analysis.
Demographics, Treatment Patterns, and Morbidity in Patients with Exercise-Induced Bronchoconstriction: An Administrative Claims Data Analysis.
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DOI：
10.2147/jaa.s338447
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发表时间：
2021
影响因子：
3.2
通讯作者：
Lugogo NL
中科院分区：
文献类型：
--
作者：
Lanz MJ;Gilbert IA;Gandhi HN;Goshi N;Tkacz JP;Lugogo NL
运动引起的支气管收缩 (EIB) 通常在运动前使用短效 β2 激动剂 (SABA) 进行治疗，以预防症状。在美国，关于美国单纯 EIB (EIBalone) 或哮喘 (EIBasthma) 患者的治疗和结果的真实世界数据有限。本研究比较了这两组患者的人口统计数据、治疗模式、发病率和治疗 EIB 的费用。对来自美国 IBM® MarketScan® Research 数据库的行政索赔进行了回顾性分析。对2011年1月1日至2016年12月31日之间填写SABA索赔的年龄≥4岁的患者进行了评估。患者根据随机 SABA 索赔进行索引，并需要在索引前和索引后具有 12 个月的连续资格、≥1 种维持药物和/或索引后 SABA 填充，并根据诊断代码指定为 EIBalone 或 EIBasthma（分别为仅 EIB 或 EIB 加哮喘）。使用描述性统计。总共有 13,480 名患者患有 EIBalone，14,862 名患者患有 EIBasthma。与 EIBasthma 相比，EIBalone 组年龄更大（平均 [SD] 20.4[13.6] vs 17.8[13.6] 岁），女性较多（60.7% vs 54.7%），且填写的 SABA 索赔较少（1.9[1.4] vs 2.5[2.2]）（所有 p<0.001）。与 EIBasthma 组相比，EIBalone 组中要求维持治疗的患者比例较小（79.9% vs 90.6%，p<0.001）。 EIBalone 组中口服或注射皮质类固醇声称的患者比例（29.4% vs 32.0%）以及哮喘和/或 EIB 相关急诊科（1.0% vs 13.0%）或门诊就诊（65.1% vs 72.3%；全部 p<0.0001）的患者比例也较低。各组之间每年口服皮质类固醇的供应天数相似（平均[SD] EIBalone：20.7[30.8] vs EIBasthma：19.8[28]天）。患有 EIBalone 或 EIBasthma 的个体表现出相当大的发病率。可能需要新的治疗范例来优化这两个患者组的结果。
Exercise-induced bronchoconstriction (EIB) is generally treated with short-acting β2-agonists (SABA) before exercising, to prevent symptoms. Real-world data on treatments and outcomes for patients with EIB alone (EIBalone), or with asthma (EIBasthma), in the USA are limited. This study compared demographics, treatment patterns, morbidity, and costs of treating EIB between these two groups of patients. Administrative claims from US IBM® MarketScan® Research databases were analyzed retrospectively. Patients aged ≥4 years filling a SABA claim between 1/1/2011 and 12/31/2016 were evaluated. Patients were indexed on a random SABA claim and required to have 12 months’ continuous eligibility pre- and post-index, ≥1 maintenance medication and/or SABA fill post-index, and were designated EIBalone or EIBasthma according to diagnostic codes (EIB only or EIB plus asthma, respectively). Descriptive statistics were used. In total, 13,480 patients had EIBalone and 14,862 had EIBasthma. Compared with EIBasthma, the EIBalone group was older (mean[SD] 20.4[13.6] vs 17.8[13.6] years), had more females (60.7% vs 54.7%), and filled fewer SABA claims (1.9[1.4] vs 2.5[2.2]) (all p<0.001). A smaller proportion of patients in the EIBalone than EIBasthma group had maintenance therapy claims (79.9% vs 90.6%, p<0.001). The EIBalone group also had a lower proportion of patients with oral or injectable corticosteroid claims (29.4% vs 32.0%) and asthma and/or EIB-related emergency department (1.0% vs 13.0%) or outpatient visits (65.1% vs 72.3%; all p<0.0001). Annual days’ supply of oral corticosteroids was similar between groups (mean[SD] EIBalone: 20.7[30.8] vs EIBasthma: 19.8[28] days). Individuals with EIBalone or EIBasthma demonstrate considerable morbidity. New treatment paradigms may be needed to optimize outcomes for both patient groups.