Janson C, de Marco R, Accordini S, Almar E, Bugiani M, Carolei A, Cazzoletti L, Cerveri I, Corsico A, Duran-Tauleria E, Gislason D, Gulsvik A, Jõgi R, Marinoni A, Martínez-Moratalla J, Pin I, Vermeire P, Jarvis D
Dept of Medical Sciences, Respiratory Medicine and Allergology, Akademiska sjukhuset, SE 751 85 Uppsala, Sweden.
Eur Respir J. 2005 Dec;26(6):1047-55. doi: 10.1183/09031936.05.00031905.
The aim of this study was to describe changes in pharmacotherapy for asthma since the early 1990s in an international cohort of young and middle-aged adults. A total of 28 centres from 14 countries participated in a longitudinal study. The study included 8,829 subjects with a mean follow-up time of 8.7 yrs. Change in the prevalence of use for medication was expressed as absolute net change (95% confidence interval) standardised to a 10-yr period. The use of anti-asthmatics was found to have increased by 3.1% (2.4-3.7%) and the prevalence of symptomatic asthma by 4.0% (3.5-4.5%). In the sample with asthma in both surveys (n=423), the use of inhaled corticosteroids increased by 12.2% (6.6-17.8%). Despite this, only 17.2% were using inhaled corticosteroids on a daily basis at follow-up. Females with continuous asthma were more likely, compared with males, and smokers with asthma, to have started using inhaled corticosteroids since the first survey. The use of anti-asthmatics has increased in a pattern consistent with current consensus on treatment. However, despite increased use of inhaled corticosteroids, a large majority of subjects with symptomatic asthma do not use this treatment on a daily basis, particularly males and smokers with asthma.
本研究的目的是描述自20世纪90年代初以来,国际队列中年轻和中年成年人哮喘药物治疗的变化。来自14个国家的28个中心参与了一项纵向研究。该研究纳入了8829名受试者,平均随访时间为8.7年。药物使用患病率的变化以绝对净变化(95%置信区间)表示,并标准化为10年期间。结果发现,抗哮喘药物的使用增加了3.1%(2.4%-3.7%),症状性哮喘的患病率增加了4.0%(3.5%-4.5%)。在两次调查中均患有哮喘的样本(n=423)中,吸入性糖皮质激素的使用增加了12.2%(6.6%-17.8%)。尽管如此,随访时只有17.2%的人每天使用吸入性糖皮质激素。与男性和哮喘吸烟者相比,持续性哮喘女性自首次调查以来更有可能开始使用吸入性糖皮质激素。抗哮喘药物的使用增加,其模式与当前的治疗共识一致。然而,尽管吸入性糖皮质激素的使用有所增加,但大多数有症状的哮喘患者并非每天都使用这种治疗方法,尤其是男性和哮喘吸烟者。