Karl Landsteiner Institute for Experimental and Clinical Pneumology, Department of Pulmonary Diseases, Hietzing Hospital, Vienna, Austria.
Karl Landsteiner Institute for Experimental and Clinical Pneumology, Department of Pulmonary Diseases, Hietzing Hospital, Vienna, Austria.
Respir Med. 2021 Jun;182:106398. doi: 10.1016/j.rmed.2021.106398. Epub 2021 Apr 14.
Evidence of the efficacy of single-inhaler triple therapy in COPD patients inferred from RCTs has not been assessed in a real-world setting in Austria. In this non-interventional study (NIS) tolerability and effectiveness of extrafine beclometasone-dipropionate, formoterol-fumarate and glycopyrronium (Trimbow® 87/5/9 μg) was evaluated in COPD patients.
A prospective NIS was conducted over 52 weeks in 24 sites in Austria. Eligible COPD patients had an indication for treatment with single-inhaler BDP/FF/G. In this study tolerability, lung function, exacerbation rate, symptom scores and CAT scores were recorded.
265 patients with moderate to very severe airflow limitation (GOLD Grade 2-4: 96.2%) and persistent symptoms (GOLD B: 62.3%, GOLD D: 34%) according to the 2018 GOLD Report were included. After 52 weeks, a significant improvement was detected in lung function (FEV, FEV% predicted and FVC; p < 0.001) and symptoms (cough, sputum and shortness of breath; p < 0.001). A clinically relevant improvement in CAT score observed at 12 weeks persisted after 52 weeks in GOLD B and GOLD D patients (p < 0.001), paralleled by a significant reduction of moderate and severe exacerbations by 57.4% and 27.3%, respectively (p < 0.001). After 52 weeks, 93.7% of the patients continued the treatment. Of 21 adverse events reported 16 were non-serious, five were serious, none were deemed drug related.
The present results support the tolerability and effectiveness of extrafine BDP/FF/G in COPD patients in a real-world setting, showing an improvement in lung function, symptom control and a significant reduction in exacerbations.
从 RCT 中推断出 COPD 患者单吸入器三联疗法的疗效证据尚未在奥地利的真实世界环境中进行评估。在这项非干预性研究(NIS)中,评估了 COPD 患者使用超细倍氯米松-二丙酸酯、福莫特罗-富马酸和格隆溴铵(Trimbow®87/5/9μg)的耐受性和有效性。
在奥地利的 24 个地点进行了为期 52 周的前瞻性 NIS。符合条件的 COPD 患者有使用单吸入器 BDP/FF/G 的治疗指征。在这项研究中,记录了耐受性、肺功能、恶化率、症状评分和 CAT 评分。
共纳入 265 名中重度气流受限(GOLD 分级 2-4:96.2%)和持续症状(GOLD B:62.3%,GOLD D:34%)的患者,根据 2018 年 GOLD 报告。52 周后,肺功能(FEV、FEV%预测值和 FVC;p<0.001)和症状(咳嗽、痰和呼吸困难;p<0.001)均显著改善。在 GOLD B 和 GOLD D 患者中,在 12 周时观察到的 CAT 评分的临床相关改善在 52 周时持续存在(p<0.001),同时中度和重度恶化分别减少了 57.4%和 27.3%(p<0.001)。52 周后,93.7%的患者继续治疗。报告的 21 起不良事件中,16 起为非严重事件,5 起为严重事件,均与药物无关。
本研究结果支持在真实世界环境中使用超细 BDP/FF/G 治疗 COPD 患者的耐受性和有效性,显示肺功能改善、症状控制和恶化显著减少。