The effects of different inhalation therapies on less symptomatic chronic obstructive pulmonary disease patients in a Chinese population: a real-world study.
The effects of different inhalation therapies on less symptomatic chronic obstructive pulmonary disease patients in a Chinese population: a real-world study.
复制标题
DOI：
10.1080/07853890.2023.2192519
复制
发表时间：
2023-12
影响因子：
4.4
通讯作者：
中科院分区：
文献类型：
--
作者：
慢性阻塞性肺病全球倡议 (GOLD) 文件建议，慢性阻塞性肺病 (COPD) 患者应分为症状较轻的组。此外，推荐单次吸入药物作为其初始吸入治疗。然而，在现实世界中，许多症状较轻的患者会接受两次或三次吸入药物作为初始治疗。本研究旨在描述吸入处方并比较不同吸入疗法对症状较轻的慢性阻塞性肺病患者的效果。这是一项观察性研究。根据 GOLD 2019 文件，招募了稳定的 COPD 患者并分为症状较轻的组，包括 A 组和 C 组。我们收集了吸入疗法处方的数据。然后将患者分为长效毒蕈碱拮抗剂（LAMA）组、长效β2受体激动剂（LABA）+吸入皮质类固醇（ICS）组、LABA + LAMA组、LABA + LAMA + ICS组。所有患者均接受为期 1 年的随访，以收集病情恶化和死亡率数据。参考GOLD文件，我们发现A组中只有45.4%的患者和C组中43.6%的患者接受了合理的吸入治疗。此外，与LABA + ICS、LABA + LAMA和LABA + LAMA + ICS组相比，LAMA组具有较高的一秒用力呼气量（FEV1）、FEV1%pred、FEV1/用力肺活量和峰值呼气流量。然而，我们在随访期间没有发现不同吸入治疗组对症状较轻的 COPD 患者的病情加重、住院治疗和死亡率有任何显着差异。超过一半症状较轻的 COPD 患者接受的吸入疗法与现实世界中中国人群的 GOLD 文件建议不一致。临床医生应向症状较轻的 COPD 患者提供 LAMA 单一吸入药物，而肺功能并不是选择初始吸入治疗的良好指标。超过一半的症状较轻的患者接受了与现实世界中国人群中 GOLD 文件建议不一致的吸入疗法。事实上，对于症状较轻的COPD患者，应推荐LAMA单一吸入药物，而肺功能并不是选择初始吸入治疗的良好指标。
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) document suggests that patients with chronic obstructive pulmonary disease (COPD) should be divided into a less symptomatic group. Moreover, single-inhaled drugs are recommended as initial inhalation therapy for them. However, many less symptomatic patients are provided double or triple-inhaled drugs as initial therapy in the real world. This study aimed to describe the inhalation prescriptions and compare the effects of different inhalation therapies on less symptomatic COPD patients. This was an observational study. Stable COPD patients were recruited and divided into a less symptomatic group including Groups A and C based on the GOLD 2019 document. We collected the data of inhalation therapies prescriptions. Then, the patients were classified into long-acting muscarinic antagonist (LAMA), long-acting β2-agonist (LABA) + inhaled corticosteroid (ICS), LABA + LAMA, and LABA + LAMA + ICS groups. All the patients were followed up for 1 year to collect exacerbation and mortality data. We found that only 45.4% of patients in Group A and 43.6% of patients in Group C received reasonable inhalation therapy in reference to the GOLD document. In addition, the LAMA group had a higher forced expiratory volume in one second (FEV1), FEV1%pred, FEV1/forced vital capacity and peak expiratory flow compared with LABA + ICS, LABA + LAMA and LABA + LAMA + ICS groups. However, we did not find any significant differences of exacerbation, hospitalization and mortality during the follow-up among different inhalation therapies groups on less symptomatic COPD patients. Over half of the less symptomatic COPD patients received inhalation therapy that were inconsistent with the GOLD document recommendations in a Chinese population in the real world. The clinicians should offer a single inhaled drug of LAMA to less symptomatic COPD patients and pulmonary function is not a good indicator for the choice of initial inhalation therapy. Over half of the less symptomatic patients received inhalation therapy that were inconsistent with the GOLD document recommendations in a Chinese population in the real world. In fact, the single inhaled drug of LAMA should be recommended and pulmonary function is not a good indicator for the choice of initial inhalation therapy in less symptomatic COPD patients.
登录
查看更多内容
DOI：
10.2147/copd.s125564
发表时间：
2017-01-01
影响因子：
2.8
作者：
Ninane, Vincent;Corhay, Jean-Louis;Lehouck, An
通讯作者：
Lehouck, An
影响因子：
158.5
作者：
Zhou, Y.;Zhong, N.;Ran, P.
通讯作者：
Ran, P.
DOI：
10.2147/copd.s182905
发表时间：
2018-01-01
影响因子：
2.8
作者：
Kobayashi, Seiichi;Hanagama, Masakazu;Yanai, Masaru
通讯作者：
Yanai, Masaru
DOI：
10.2147/copd.s191362
发表时间：
2019-01-01
影响因子：
2.8
作者：
Lee, Seung Jun;Yun, Sang Suk;Lee, Jong Deog
通讯作者：
Lee, Jong Deog
影响因子：
76.2
作者：
Soriano, Joan B.;Kendrick, Parkes J.;Zhang, Yunquan
通讯作者：
Zhang, Yunquan