Chanoine Sébastien, Dumas Orianne, Benmerad Meriem, Pison Christophe, Varraso Raphaëlle, Gormand Frédéric, Just Jocelyne, Le Moual Nicole, Bedouch Pierrick, Bousquet Jean, Kauffmann Francine, Pin Isabelle, Siroux Valérie
INSERM, Institut Albert Bonniot, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, F-38000, Grenoble, France; Université Grenoble Alpes, Institut Albert Bonniot, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, F-38000, Grenoble, France; CHU de Grenoble, Institut Albert Bonniot, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, F-38000, Grenoble, France; Université Grenoble Alpes, School of Pharmacy, F-38000, Grenoble, France; CHU de Grenoble, Pharmacy Department, F-38000, Grenoble, France.
Pharmacoepidemiol Drug Saf. 2015 Mar;24(3):246-55. doi: 10.1002/pds.3639. Epub 2014 Jun 26.
The aim of this study was to apply a propensity score approach to assess the long-term benefits of inhaled corticosteroids (ICS) on respiratory health in asthma.
This analysis was conducted on adults with persistent asthma from the Epidemiological study on the Genetics and Environment of Asthma, a 12-year follow-up study. ICS exposure was assessed by questionnaire. Change in lung function over the follow-up period, asthma control, and health-related quality of life (asthma quality of life questionnaire) were assessed by standardized and validated methods.
Among 245 adults with persistent asthma, 78 (31.8%) were regularly/continuously exposed to ICS (≥6 months/year, ICS++ ) and 167 never/irregularly exposed to ICS (<6 months/year, ICS+/- ) over the follow-up period. Compared with ICS+/- subjects, a nonsignificant trend for a slower lung function decline (mL/year) was observed in ICS++ subjects (β [95%CI] = -11.4 [-24.9; 2.0]). The ICS++ subjects did not have better controlled asthma and higher health-related quality of life as compared with ICS+/- subjects.
Applying a propensity score method did not offer evidence of a statistical significant long-term benefit of ICS on respiratory health in adults with persistent asthma regularly or continuously exposed to ICS over a long period.
本研究旨在应用倾向评分法评估吸入性糖皮质激素（ICS）对哮喘患者呼吸健康的长期益处。
本分析针对哮喘遗传与环境流行病学研究中的成年持续性哮喘患者进行，该研究为期12年的随访研究。通过问卷调查评估ICS暴露情况。采用标准化和验证过的方法评估随访期间的肺功能变化、哮喘控制情况以及健康相关生活质量（哮喘生活质量问卷）。
在245名成年持续性哮喘患者中，78名（31.8%）在随访期间定期/持续暴露于ICS（≥6个月/年，ICS++），167名从未/不定期暴露于ICS（<6个月/年，ICS+/-）。与ICS+/-组相比，ICS++组肺功能下降速度（mL/年）有减缓趋势，但无统计学意义（β[95%CI]= -11.4[-24.9; 2.0]）。与ICS+/-组相比，ICS++组哮喘控制情况及健康相关生活质量并未更好。
应用倾向评分法未发现长期规律或持续暴露于ICS的成年持续性哮喘患者中，ICS对呼吸健康有统计学显著的长期益处。
