美国索赔数据库中哮喘生物制剂使用的持续性。
Persistence of asthma biologic use in a US claims database.
机构信息
Department of Medicine, Mayo Clinic, Phoenix, Arizona; Division of Allergy, Asthma, and Clinical Immunology, Mayo Clinic, Scottsdale, Arizona.
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.
出版信息
Ann Allergy Asthma Immunol. 2021 Dec;127(6):648-654. doi: 10.1016/j.anai.2021.04.026. Epub 2021 May 7.
BACKGROUND
Little is known on the persistence of asthma biologic use in clinical practice.
OBJECTIVE
To evaluate the persistence of asthma biologic use and time to clinical response in clinical practice.
METHODS
A cohort of people with asthma who used at least 1 asthma biologic was constructed using data from 2003 to 2019 in the OptumLabs Data Warehouse. Treatment persistence was defined by the length of time that a person continuously used an asthma biologic, allowing for a lapse in use up to 4 months before confirming that a person stopped. Clinical response to treatment (defined as a decline in asthma exacerbations of at least 50% compared with the 6 months before starting an asthma biologic) was described over time and in relation to biologic persistence.
RESULTS
There were 9575 people who had at least 1 episode of asthma biologic use. There were 5319 people (64%, 95% confidence interval, 63%-65%) who completed 6 months or more on an asthma biologic and 3284 (45%, 95% confidence interval, 44%-46%) who completed 12 months or more. Of people with 1 or more asthma exacerbation 6 months before index biologic use, 63%, 76%, 80%, and 81% realized a 50% or more reduction in postindex asthma exacerbations in the first 6 months, 6 to 12 months, 12 to 18 months, and 18 to 24 months, respectively.
CONCLUSION
Between 48% and 64% of people remained on an asthma biologic for 6 months or more after first use. Most people who achieved a reduction in asthma exacerbations did so in the first 6 months of treatment.
背景
关于哮喘生物制剂在临床实践中的持续使用情况知之甚少。
目的
评估哮喘生物制剂在临床实践中的持续使用情况和临床反应时间。
方法
使用 2003 年至 2019 年 OptumLabs 数据仓库中的数据构建了一个使用至少 1 种哮喘生物制剂的哮喘患者队列。治疗持续性定义为一个人连续使用哮喘生物制剂的时间长度，允许在确认一个人停止使用之前有长达 4 个月的停药期。描述了随着时间的推移和与生物制剂持续使用相关的治疗临床反应（定义为与开始使用哮喘生物制剂前 6 个月相比，哮喘恶化至少下降 50%）。
结果
共有 9575 人至少有 1 次哮喘生物制剂使用。有 5319 人（64%，95%置信区间，63%-65%）完成了 6 个月或更长时间的哮喘生物制剂治疗，3284 人（45%，95%置信区间，44%-46%）完成了 12 个月或更长时间的治疗。在索引生物制剂使用前 6 个月有 1 次或多次哮喘加重的患者中，分别有 63%、76%、80%和 81%在使用索引生物制剂后的前 6 个月、6 至 12 个月、12 至 18 个月和 18 至 24 个月内实现了哮喘恶化减少 50%或更多。
结论
首次使用后，有 48%至 64%的人继续使用哮喘生物制剂 6 个月或更长时间。大多数实现哮喘恶化减少的患者是在治疗的前 6 个月内实现的。
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