LASER, Tour CIT, 3 Rue de l'Arrivée, 75015, Paris, France.
LASER, Tour CIT, 3 Rue de l'Arrivée, 75015, Paris, France.
Respir Med. 2018 Nov;144:42-49. doi: 10.1016/j.rmed.2018.10.002. Epub 2018 Oct 2.
To describe the clinical and economic burden of severe asthma in France over 12 months.
Data were retrieved from the observational, prospective "Cohorte Obstruction Bronchique et Asthme" (COBRA) cohort, which has enrolled nearly 1000 asthma patients since 2007 from throughout France. Patients undergoing treatment with GINA step-4 or 5 medications uninterruptedly for 12 months (thus defining "severe asthma") were identified and their clinical data used to describe the clinical burden of asthma (exacerbations, symptoms outside exacerbations, and level of asthma control). Patients' utilization of healthcare resources was described and used to estimate the direct medical costs incurred to treat severe asthma.
155 patients were included in the present study. Over the 12-month period of interest, 128 (83%) patients experienced at least one asthma exacerbation, 22 (14%) patients were hospitalized for asthma, 133 (86%) patients experienced continuous symptoms outside exacerbations, and 77 (50%) patients experienced important limitations in daily life activities. The median number of asthma-related drugs used was 4. The mean estimated annual asthma-related cost was 8,222 euros (standard deviation, SD = 11,886), including 7,229 euros (SD = 11,703) for controller medications.
Symptoms outside exacerbation periods are highly prevalent in severe asthma patients, for whom the main driver of medical costs is controller medication.
描述法国重度哮喘患者在 12 个月内的临床和经济负担。
数据来自于一项观察性、前瞻性的“COBRA 队列研究”，该研究自 2007 年以来在法国各地招募了近 1000 名哮喘患者。确定了连续 12 个月接受 GINA 第 4 或第 5 步治疗药物治疗（因此定义为“重度哮喘”）的患者，并使用其临床数据来描述哮喘的临床负担（加重期、加重期外的症状和哮喘控制水平）。描述了患者对医疗资源的利用情况，并用于估计治疗重度哮喘的直接医疗费用。
本研究纳入了 155 例患者。在研究期间的 12 个月内，128 例（83%）患者至少经历了一次哮喘加重，22 例（14%）患者因哮喘住院，133 例（86%）患者在加重期外持续出现症状，77 例（50%）患者日常生活活动受到严重限制。与哮喘相关的药物中位数使用数为 4 种。估计哮喘相关的年平均费用为 8222 欧元（标准差，SD=11886），其中控制器药物的费用为 7229 欧元（SD=11703）。
在重度哮喘患者中，加重期外的症状非常普遍，而这些患者医疗费用的主要驱动因素是控制器药物。
