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亚洲哮喘患者布地奈德/福莫特罗维持缓解治疗的真实疗效:SMARTASIA 研究。

Real-life effectiveness of budesonide/formoterol maintenance and reliever therapy in asthma patients across Asia: SMARTASIA study.

机构信息

Respiratory Research Institute, 1st Affiliated Hospital of Guangzhou Medical College, Guangzhou, China.

出版信息

BMC Pulm Med. 2013 Apr 4;13:22. doi: 10.1186/1471-2466-13-22.

Abstract

BACKGROUND

The use of budesonide/formoterol in a single inhaler for both maintenance and reliever therapy is a recommended option for treatment of persistent asthma not responding well to inhaled corticosteroid (ICS) alone.

METHODS

This was a multi-centre open-label study on patients whose asthma condition remained inadequately controlled by various asthma treatments other than budesonide/formoterol. After a 2-week run-in period, eligible patients underwent a 12-week treatment period with budesonide/formoterol (Symbicort SMART(®), 160/4.5 μg) twice daily plus as needed. Patient's asthma control and quality of life were assessed using the 5-item Asthma Control Questionnaire (ACQ-5) and the standardized Asthma Quality of Life Questionnaire (AQLQ-S), respectively.

RESULTS

A total of 862 eligible asthma patients who have had asthma for a mean duration of 10.73 ± 12.03 years entered a 12-week treatment with budesonide/formoterol maintenance and reliever therapy. During treatment, ACQ-5 score improved significantly by 0.58 ± 0.93 (95% CI, 0.51 to 0.64, P < 0.0001) from the baseline level of 1.62 ± 1.00. AQLQ(S) score improved by 0.70 ± 0.89 (95% CI, 0.64 to 0.76, P < 0.0001) from baseline. Asthma symptom score was also reduced significantly (P < 0.0001); between run-in and treatment periods, night- and day-time symptom scores were reduced by 0.32 ± 0.54 (95% CI, 0.28 to 0.35) and 0.30 ± 0.52 (95% CI, 0.27 to 0.34), respectively. The percentage of nights with awakenings due to asthma symptoms was reduced by 11.09 ± 26.13% (95% CI, 9.34 to 12.85%), while the percentage of asthma-control and symptom-free days increased by 20.90 ± 34.40% (95% CI, 18.59 to 23.21%) and 23.89 ± 34.62% (95% CI, 21.56 to 26.21%), respectively (P < 0.0001). Together with the improvement in asthma control, the number of night- and day-time inhalations of as-needed reliever medication decreased by 0.30 ± 0.82 (95% CI, 0.24 to 0.35) inhalations and 0.30 ± 0.97 (95% CI, 0.23 to 0.36) inhalations, respectively (P < 0.0001). No unexpected adverse events were reported.

CONCLUSION

During treatment of inadequately controlled asthmatic patients with budesonide/formoterol maintenance and reliever therapy, significant improvement in patients' asthma control and reductions in asthma symptoms and as-needed medication use was observed. Patients' quality of life was improved and the treatment was well tolerated.

TRIAL REGISTRATION

ClinicalTrial.gov: (NCT00939341).

摘要

背景

布地奈德/福莫特罗单一吸入器在维持和缓解治疗中的应用是治疗对单独吸入皮质激素反应不佳的持续性哮喘的推荐选择。

方法

这是一项多中心、开放性标签研究,纳入了除布地奈德/福莫特罗以外的各种哮喘治疗方案未能充分控制哮喘的患者。在 2 周的导入期后,符合条件的患者接受了 12 周的布地奈德/福莫特罗(Symbicort SMART®,160/4.5μg)每日两次维持治疗和按需治疗。使用 5 项哮喘控制问卷(ACQ-5)和标准化哮喘生活质量问卷(AQLQ-S)分别评估患者的哮喘控制和生活质量。

结果

共有 862 名符合条件的哮喘患者入组,他们的哮喘平均病程为 10.73±12.03 年,接受了布地奈德/福莫特罗维持和缓解治疗 12 周。治疗期间,ACQ-5 评分从基线水平的 1.62±1.00 显著改善 0.58±0.93(95%CI,0.51 至 0.64,P<0.0001)。AQLQ-S 评分从基线水平改善了 0.70±0.89(95%CI,0.64 至 0.76,P<0.0001)。哮喘症状评分也显著降低(P<0.0001);在导入期和治疗期间,夜间和日间症状评分分别降低了 0.32±0.54(95%CI,0.28 至 0.35)和 0.30±0.52(95%CI,0.27 至 0.34)。因哮喘症状而夜间觉醒的百分比降低了 11.09±26.13%(95%CI,9.34 至 12.85%),而哮喘控制和无症状天数的百分比分别增加了 20.90±34.40%(95%CI,18.59 至 23.21%)和 23.89±34.62%(95%CI,21.56 至 26.21%)(P<0.0001)。随着哮喘控制的改善,按需缓解药物的夜间和日间吸入次数分别减少了 0.30±0.82(95%CI,0.24 至 0.35)和 0.30±0.97(95%CI,0.23 至 0.36)(P<0.0001)。未报告意外不良事件。

结论

在使用布地奈德/福莫特罗维持和缓解治疗控制不佳的哮喘患者中,观察到患者的哮喘控制显著改善,哮喘症状和按需药物使用减少。患者的生活质量得到改善,治疗耐受性良好。

试验注册

ClinicalTrials.gov:(NCT00939341)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eafe/3637584/fccafa19ccb9/1471-2466-13-22-1.jpg

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