Medical Research Institute of New Zealand, Wellington, New Zealand; School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand.
Medical Research Institute of New Zealand, Wellington, New Zealand.
J Allergy Clin Immunol Pract. 2023 Sep;11(9):2757-2764.e5. doi: 10.1016/j.jaip.2023.04.041. Epub 2023 May 11.
In June 2020, the New Zealand (NZ) adolescent and adult asthma guidelines recommended budesonide/formoterol, taken as maintenance and/or reliever therapy, as the preferred therapeutic approach.
To investigate whether these recommendations were associated with changes in clinical practice indicated by asthma medication use trends.
NZ national dispensing data for inhaler medications from January 2010 to December 2021 were reviewed. Monthly "dispensings" of inhaled budesonide/formoterol, inhaled corticosteroid (ICS), other ICS/long-acting β-agonists (LABA), and inhaled short-acting β-agonists (SABA), for the 12+ age group, were displayed graphically with piecewise regression used to produce plots of rates by time with a July 1, 2020, break point. The number of dispensings in the last 6 months that data were available (July-December 2021) was compared with the corresponding period, July-December 2019.
Budesonide/formoterol dispensing increased markedly after July 1, 2020 (regression coefficient 41.1 inhalers dispensed/100,000 population per month [95% confidence interval (CI): 36.3-45.6, P < .0001]; 64.7% increase in the number of dispensings between July-December 2019 and July-December 2021), in contrast to "other ICS/LABA" (regression coefficient: -15.9 [95% CI: -22.2 to -9.6, P < .0001]; -1.7% decrease) and SABA (regression coefficient: -14.7 [95% CI: -29.7 to 0.3, P = .055]; -10.6% decrease), respectively.
In NZ, a progressive increase in budesonide/formoterol dispensing, accompanied by a reduction in SABA and "other ICS/LABA" dispensing, occurred after publication of the 2020 NZ asthma guidelines. While acknowledging the limitations in the interpretation of temporal associations, these findings suggest that the transition to ICS/formoterol reliever-based therapy can be achieved if recommended and promoted as the preferred therapeutic approach in national guidelines.
2020 年 6 月，新西兰（NZ）青少年和成人哮喘指南建议布地奈德/福莫特罗作为维持和/或缓解治疗的首选治疗方法。
研究这些建议是否与哮喘药物使用趋势所表明的临床实践变化有关。
审查了 2010 年 1 月至 2021 年 12 月的国家吸入器药物配药数据。以 12 岁以上人群的每月吸入布地奈德/福莫特罗、吸入皮质类固醇（ICS）、其他 ICS/长效β-激动剂（LABA）和吸入短效β-激动剂（SABA）的“配药”数量进行图形显示，分段回归用于生成按时间划分的速率图，2020 年 7 月 1 日为断点。将 2021 年 7 月至 12 月（最后 6 个月的数据可用）的数据与 2019 年同期进行比较。
2020 年 7 月 1 日之后，布地奈德/福莫特罗的配药量显著增加（回归系数为 41.1 个吸入器/每 10 万人每月[95%置信区间（CI）：36.3-45.6，P<.0001]；2019 年 7 月至 12 月与 2021 年 7 月至 12 月之间的配药量增加了 64.7%），而“其他 ICS/LABA”（回归系数：-15.9[95%CI：-22.2 至-9.6，P<.0001]；减少 1.7%）和 SABA（回归系数：-14.7[95%CI：-29.7 至 0.3，P=0.055]；减少 10.6%）则相反。
在 NZ，在 2020 年 NZ 哮喘指南发表后，布地奈德/福莫特罗的配药量逐渐增加，同时 SABA 和“其他 ICS/LABA”的配药量减少。尽管承认对时间关联的解释存在限制，但这些发现表明，如果在国家指南中推荐和推广作为首选治疗方法，可以实现向 ICS/福莫特罗缓解治疗的转变。
