与丙酸氟替卡松相比，哮喘患者采用糠酸莫米松吸入治疗能降低短效β2受体激动剂的使用，增加治疗依从性
2011/05/12
摘要
目的：糠酸莫米松(MF)（每日1次）与丙酸氟替卡松(FP)（每日2次）治疗哮喘存在着疗效差异，这也会影响患者的治疗依从性和短效β2受体激动剂(SABA)的使用。
方法：通过对数据库的回顾性分析，寻找分别采用MF和FP进行初始治疗的两个配对的哮喘患者队列（年龄12-65岁）。对无、1～4个、5～8个及更多SABA preindex药物治疗的患者进行分层，分别归为A、B、C、D组。双变量分析比较postindex SABA需求、治疗依从性和哮喘恶化；多变量分析比较postindex SABA需求。
结果：对A组（每个队列n = 2517）和B组（每个队列n = 2329）配对的患者进行分析，C组和D组样本量不足。Postindex双变量分析显示，与FP队列相比，MF队列SABA需求较少（A组分别为0.80 vs. 1.17 [P < 0.0001]; B组分别为1.39 vs. 1.58 [P < 0.0001]），对药物治疗的依从性也较好(A组分别为24% vs. 15% [P < 0.0001]; B组分别为27% vs. 15% [P < 0.0001])，哮喘恶化次数也更少(A组分别为0.17 vs. 0.19 [P = 0.011]; B组分别为0.17 vs. 0.21 [P = 0.008])。多变量分析显示，与FP队列相比，MF队列中A组和B组患者具有更少的SABA需求(P < 0.0001)。
结论：对SABA需求、治疗依从性和哮喘恶化的分析显示，与每日两次FP治疗相比，每日1次MF治疗的患者具有更好的哮喘控制。
(刘国梁 审校)
Value Health. 2011 Mar-Apr;14(2):339-346.
Treatment with Inhaled Mometasone Furoate Reduces Short-Acting β(2) Agonist Claims and Increases Adherence Compared to Fluticasone Propionate in Asthma Patients.
Navaratnam P, Friedman HS, Urdaneta E.
Eympres Research, LLC, Hilliard, OH, USA.
Abstract
OBJECTIVES: Differences between mometasone furoate (MF), administered once daily, and fluticasone propionate (FP), administered twice daily, dosing regimens may affect adherence and short-acting β(2) agonist (SABA) use. The objective of this analysis was to compare asthma control outcomes in matched cohorts of MF- and FP-treated asthma patients stratified by SABA claims.
METHODS: A retrospective pharmacy claims database analysis identified matched cohorts of asthma patients (aged 12-65 years) who initiated treatment with MF or FP. Patients with none, one to four, five to eight, or more than eight SABA preindex claims were stratified to categories A, B, C, and D, respectively. Bivariate analyses compared postindex SABA canister claims, adherence, and exacerbations; multivariate analyses compared postindex SABA canister claims.
RESULTS: Matched patients in categories A (n = 2517 per cohort) and B (n = 2329 per cohort) were analyzed; insufficient sample sizes were identified for categories C and D. Postindex bivariate analyses indicated that MF cohorts had fewer SABA claims compared to FP cohorts (category A, 0.80 vs. 1.17 [P < 0.0001]; category B, 1.39 vs. 1.58 [P < 0.0001]), better adherence to the index drug (category A, 24% vs. 15% [P < 0.0001]; category B, 27% vs. 15% [P < 0.0001]), and fewer exacerbations (category A, 0.17 vs. 0.19 [P = 0.011]; category B, 0.17 vs. 0.21 [P = 0.008]). Multivariate analyses indicated that MF cohorts had fewer postindex SABA claims compared to FP cohorts in categories A and B (P < 0.0001).
CONCLUSIONS: Data for SABA claims, treatment adherence, and exacerbations suggest that, compared to twice-daily FP, once-daily MF may provide better asthma control
Value Health. 2011 Mar-Apr;14(2):339-46.
目的：糠酸莫米松(MF)（每日1次）与丙酸氟替卡松(FP)（每日2次）治疗哮喘存在着疗效差异，这也会影响患者的治疗依从性和短效β2受体激动剂(SABA)的使用。
方法：通过对数据库的回顾性分析，寻找分别采用MF和FP进行初始治疗的两个配对的哮喘患者队列（年龄12-65岁）。对无、1～4个、5～8个及更多SABA preindex药物治疗的患者进行分层，分别归为A、B、C、D组。双变量分析比较postindex SABA需求、治疗依从性和哮喘恶化；多变量分析比较postindex SABA需求。
结果：对A组（每个队列n = 2517）和B组（每个队列n = 2329）配对的患者进行分析，C组和D组样本量不足。Postindex双变量分析显示，与FP队列相比，MF队列SABA需求较少（A组分别为0.80 vs. 1.17 [P < 0.0001]; B组分别为1.39 vs. 1.58 [P < 0.0001]），对药物治疗的依从性也较好(A组分别为24% vs. 15% [P < 0.0001]; B组分别为27% vs. 15% [P < 0.0001])，哮喘恶化次数也更少(A组分别为0.17 vs. 0.19 [P = 0.011]; B组分别为0.17 vs. 0.21 [P = 0.008])。多变量分析显示，与FP队列相比，MF队列中A组和B组患者具有更少的SABA需求(P < 0.0001)。
结论：对SABA需求、治疗依从性和哮喘恶化的分析显示，与每日两次FP治疗相比，每日1次MF治疗的患者具有更好的哮喘控制。
(刘国梁 审校)
Value Health. 2011 Mar-Apr;14(2):339-346.
Treatment with Inhaled Mometasone Furoate Reduces Short-Acting β(2) Agonist Claims and Increases Adherence Compared to Fluticasone Propionate in Asthma Patients.
Navaratnam P, Friedman HS, Urdaneta E.
Eympres Research, LLC, Hilliard, OH, USA.
Abstract
OBJECTIVES: Differences between mometasone furoate (MF), administered once daily, and fluticasone propionate (FP), administered twice daily, dosing regimens may affect adherence and short-acting β(2) agonist (SABA) use. The objective of this analysis was to compare asthma control outcomes in matched cohorts of MF- and FP-treated asthma patients stratified by SABA claims.
METHODS: A retrospective pharmacy claims database analysis identified matched cohorts of asthma patients (aged 12-65 years) who initiated treatment with MF or FP. Patients with none, one to four, five to eight, or more than eight SABA preindex claims were stratified to categories A, B, C, and D, respectively. Bivariate analyses compared postindex SABA canister claims, adherence, and exacerbations; multivariate analyses compared postindex SABA canister claims.
RESULTS: Matched patients in categories A (n = 2517 per cohort) and B (n = 2329 per cohort) were analyzed; insufficient sample sizes were identified for categories C and D. Postindex bivariate analyses indicated that MF cohorts had fewer SABA claims compared to FP cohorts (category A, 0.80 vs. 1.17 [P < 0.0001]; category B, 1.39 vs. 1.58 [P < 0.0001]), better adherence to the index drug (category A, 24% vs. 15% [P < 0.0001]; category B, 27% vs. 15% [P < 0.0001]), and fewer exacerbations (category A, 0.17 vs. 0.19 [P = 0.011]; category B, 0.17 vs. 0.21 [P = 0.008]). Multivariate analyses indicated that MF cohorts had fewer postindex SABA claims compared to FP cohorts in categories A and B (P < 0.0001).
CONCLUSIONS: Data for SABA claims, treatment adherence, and exacerbations suggest that, compared to twice-daily FP, once-daily MF may provide better asthma control
Value Health. 2011 Mar-Apr;14(2):339-46.
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白三烯受体拮抗剂联合吸入激素治疗能改善支气管哮喘患者的生命质量：来自日本东京郊区的调查
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严重难以控制的哮喘采用奥玛珠单抗治疗7年的临床疗效
