The future exacerbation and mortality of different inhalation therapies among patients with chronic obstructive pulmonary disease in various GOLD groups: a focus on the GOLD 2017 and GOLD 2023 reports.
The future exacerbation and mortality of different inhalation therapies among patients with chronic obstructive pulmonary disease in various GOLD groups: a focus on the GOLD 2017 and GOLD 2023 reports.
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DOI：
10.1177/17534666231213715
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发表时间：
2023-01
影响因子：
4.3
通讯作者：
Chen, Ping
中科院分区：
文献类型：
--
作者：
Song, Qing;Cheng, Wei;Liu, Cong;Li, Xueshan;Lin, Ling;Peng, Yating;Zeng, Yuqin;Yi, Rong;Liu, Yi;Li, Xin;Chen, Yan;Cai, Shan;Chen, Ping
关键词：
全球慢性阻塞性肺疾病倡议（GOLD） 2023报告修订了联合评估，将C组和D组合并为E组，并修订了初始吸入治疗建议。本研究旨在基于GOLD 2017和GOLD 2023报告，分析不同组慢性阻塞性肺疾病（COPD）患者不同吸入疗法的未来加重和死亡率。这是一项多中心回顾性研究。从12家医院建立的数据库中纳入稳定期COPD患者。根据GOLD 2017和GOLD 2023报告，将患者分为A、B、C、D和E组。然后将患者分为长效毒蕈碱拮抗剂（LAMA）、长效β2激动剂(LABA) +吸入性皮质类固醇（ICS）、LABA + LAMA、LABA + LAMA + ICS亚组。收集1年随访期间加重和死亡数据。4623例患者分为A组（15.0%）、B组（37.8%）、C组（7.3%）、D组（39.9%）、E组（47.2%）。A、c组不同吸入疗法的加重、频繁加重和死亡率无差异。B、D、e组LABA + LAMA或LABA + LAMA + ICS治疗的患者加重和频繁加重发生率低于LAMA或LABA + ICS治疗的患者。A组与c组联合使用不同吸入疗法后的死亡率无差异，A组推荐单LAMA治疗，B组和E组推荐LABA + LAMA治疗，这与GOLD 2023报告一致。然而，值得考虑将A组和C组合并为一个组，并推荐mono-LAMA作为初始吸入治疗。
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 report revised the combined assessment, merged the C and D groups into the E group, and revised the initial inhalation therapy recommendation. This study aimed to analyze the future exacerbation and mortality of different inhalation therapies among patients with chronic obstructive pulmonary disease (COPD) in various groups based on the GOLD 2017 and GOLD 2023 reports. This is a multicenter and retrospective study. Stable COPD patients from the database setup by 12 hospitals were enrolled. The patients were divided into Groups A, B, C, D, and E according to the GOLD 2017 and GOLD 2023 reports. 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 subgroups. Data on exacerbation and death during 1 year of follow-up were collected. A total of 4623 patients were classified into Group A (15.0%), Group B (37.8%), Group C (7.3%), Group D (39.9%), and Group E (47.2%). The exacerbation, frequent exacerbation, and mortality showed no differences between different inhalation therapies in Groups A and C. Patients treated with LABA + LAMA or LABA + LAMA + ICS had a lower incidence of exacerbation and frequent exacerbation than patients treated with LAMA or LABA + ICS in Groups B, D, and E. The exacerbation, frequent exacerbation, and mortality showed no differences between different inhalation therapies after combining Groups A with C. Patients in Group A should be recommended to undergo mono-LAMA, while patients in Groups B and E should be recommended treatment with LABA + LAMA, which is consistent with the GOLD 2023 report. However, it is worth considering merging Groups A and C into a single group and recommending mono-LAMA as the initial inhalation therapy.
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影响因子：
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