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中国哮喘患者中短效β2 受体激动剂的处方模式和临床结局:SABINA 计划在中国内地的观察性研究。

Short-acting beta-2 agonist prescription patterns and clinical outcomes in Chinese patients with asthma: an observational study in mainland China for the SABINA programme.

机构信息

Department of Pulmonary and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.

Department of Pulmonary and Critical Care Medicine, Shanghai Putuo District People's Hospital, Shanghai, China.

出版信息

Ther Adv Respir Dis. 2022 Jan-Dec;16:17534666221115054. doi: 10.1177/17534666221115054.

Abstract

OBJECTIVES

The SABINA CHINA study aimed to determine prescription data for asthma medication with a focus on SABA and ICS in a representative population of patients with asthma in China.

METHODS

SABINA China was a multicentre, observational, cross-sectional study with data collected retrospectively from a convenience sample of 25 tertiary centres across China. Patients (age ⩾ 12 years) with ⩾3 consultations/year were enrolled. Data were collected on clinical characteristics, asthma severity, and symptom control (as per GINA 2017), treatment and history of severe exacerbations over the past year. SABA over-prescription was defined as ⩾3 SABA canisters/year. Descriptive statistics are presented.

RESULTS

Between March and August 2020, 498 patients were included in the outcome analysis. Mean (SD) age was 48.7 (15.0) years, 57.9% were female and 91% had moderate-to-severe asthma ( = 453). Overall, 12.5% ( = 62) and 26.4% ( = 131) of patients had uncontrolled and partly controlled asthma, respectively. SABA add-on was prescribed to 20.3% ( = 101) of patients; one patient with moderate-to-severe asthma was prescribed SABA-alone. SABA over-prescription in the overall population was 4.0% ( = 20; all with moderate-to-severe asthma) and 19.8% (20/101) among those prescribed SABA add-on. In the mild asthma group, 50% ( = 22) were prescribed ICS/LABA and 43.2% ( = 19) were prescribed LTRA. Among those with moderate-to-severe asthma, 97.4% ( = 441) were prescribed ICS/LABA and 55.0% ( = 249) were prescribed LTRA. Approximately 30% of patients ( = 149) experienced ⩾1% and 6.6% ( = 33) ⩾3 severe exacerbations in the preceding year; mean annual number of severe exacerbation/patient was 0.6 (1.2). Among those prescribed SABA add-on, ICS/LABA and LTRA (non-mutually exclusive groups due to overlapping prescriptions), 54.5%, 29.9%, and 35.3% had ⩾1 severe exacerbations, respectively.

CONCLUSION

Among patients with predominantly moderate-to-severe asthma managed in tertiary care and were prescribed SABA, 1 in 5 received ⩾3 canisters/year. Fewer patients who received ICS/LABA prescriptions experienced annual exacerbations than those prescribed SABA add-on.

摘要

目的

SABINA CHINA 研究旨在确定哮喘药物处方数据,重点关注中国哮喘患者代表性人群中的短效 β2 受体激动剂(SABA)和吸入性皮质类固醇(ICS)。

方法

SABINA China 是一项多中心、观察性、横断面研究,从中国 25 家三级中心的便利样本中回顾性收集数据。每年就诊 ⩾3 次的 ⩾12 岁患者入选。收集临床特征、哮喘严重程度和症状控制(按 GINA 2017 标准)、治疗和过去 1 年严重加重史的数据。SABA 过度处方定义为 ⩾3 个 SABA 罐/年。呈现描述性统计数据。

结果

2020 年 3 月至 8 月期间,498 例患者纳入结局分析。平均(SD)年龄为 48.7(15.0)岁,57.9%为女性,91%为中重度哮喘( = 453)。总体而言,12.5%( = 62)和 26.4%( = 131)的患者哮喘未得到控制和部分控制。20.3%( = 101)的患者加用了 SABA;1 例中重度哮喘患者单独处方了 SABA。总体人群中 SABA 过度处方率为 4.0%( = 20;均为中重度哮喘),加用 SABA 的患者中 SABA 过度处方率为 19.8%(20/101)。轻度哮喘组中,50%( = 22)患者处方 ICS/LABA,43.2%( = 19)患者处方 LTRA。中重度哮喘患者中,97.4%( = 441)患者处方 ICS/LABA,55.0%( = 249)患者处方 LTRA。约 30%( = 149)的患者在过去 1 年中经历了 ⩾1%的严重加重,6.6%( = 33)经历了 ⩾3 次严重加重;患者每年严重加重的平均次数为 0.6(1.2)次。在加用 SABA 的患者中,ICS/LABA 和 LTRA(由于重叠处方而不是互斥组)的患者中,分别有 54.5%、29.9%和 35.3%经历了 ⩾1 次严重加重。

结论

在接受三级护理且处方 SABA 的主要为中重度哮喘患者中,1/5 患者接受了 ⩾3 个罐/年的治疗。接受 ICS/LABA 处方的患者每年经历的加重次数少于接受 SABA 附加治疗的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b92/9449520/fe9b7f7c0e4c/10.1177_17534666221115054-fig1.jpg

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