Kato Chihiro, Wang Dong, Nakamura Noriko, Sasajima Takayoshi, Yoshisue Hajime
Clinical Development & Analytics, Novartis Pharma K.K., Tokyo, Japan.
Respiratory Medical Franchise, Novartis Pharma K.K., Tokyo, Japan.
Open Respir Med J. 2022 Feb 8;16:e187430642112240. doi: 10.2174/18743064-v16-e2112240. eCollection 2022.
To evaluate the long-term safety and efficacy of glycopyrronium (GLY) in patients with COPD in a real-world setting in Japan.
This 52-week, multicentre, post-marketing surveillance conducted in Japan, between February 2013 and August 2019, included patients using GLY for the first time for the relief of airway obstructive disorder-related symptoms. Safety outcomes included incidence of adverse events (AEs), serious AEs (SAEs), adverse drug reactions (ADRs), serious ADRs (SADRs) and priority variables included cardiovascular/cerebrovascular (CCV) AEs and anticholinergic AEs during the 52-week period. Safety outcomes were also assessed in elderly patients. Efficacy outcomes included physician's global assessment, COPD assessment test (CAT) and lung function test.
Of the 1,331 patients registered for this surveillance, safety and efficacy outcomes were evaluated in 1,277 patients. In the safety analysis population, the incidence of AEs was 15.51%, SAEs 4.70%, ADRs 5.01% and SADRs 0.31%. The CCV AEs and anticholinergic AEs were reported by 0.70% and 2.58% patients, respectively. Physician's global assessment showed that the overall response rate at the last assessment was 70%. The mean (95% CI) CAT scores decreased from the start of treatment to Week 52 with GLY, (-6.2 [-7.0 to -5.4]). Lung function in terms of trough FEV and FVC improved over time from the start of GLY to Week 52.
GLY demonstrated an acceptable long-term safety profile with no new safety concerns in a real-life setting. It demonstrated improvement in lung function and symptom control in Japanese COPD patients.
在日本的实际临床环境中评估格隆溴铵(GLY)用于慢性阻塞性肺疾病(COPD)患者的长期安全性和有效性。
这项于2013年2月至2019年8月在日本进行的为期52周的多中心上市后监测,纳入了首次使用GLY缓解气道阻塞性疾病相关症状的患者。安全性指标包括不良事件(AE)、严重不良事件(SAE)、药物不良反应(ADR)、严重药物不良反应(SADR)的发生率,主要指标包括52周期间的心血管/脑血管(CCV)AE和抗胆碱能AE。还对老年患者的安全性指标进行了评估。有效性指标包括医生整体评估、慢性阻塞性肺疾病评估测试(CAT)和肺功能测试。
在登记参加本次监测的1331例患者中,对1277例患者进行了安全性和有效性评估。在安全性分析人群中,AE的发生率为15.51%,SAE为4.70%,ADR为5.01%,SADR为0.31%。分别有0.70%和2.58%的患者报告了CCV AE和抗胆碱能AE。医生整体评估显示,末次评估时的总体缓解率为70%。使用GLY治疗从开始至第52周,CAT评分均值(95%CI)下降了(-6.2 [-7.0至-5.4])。从开始使用GLY至第52周,肺功能指标低谷期第一秒用力呼气容积(FEV)和用力肺活量(FVC)随时间改善。
在实际临床环境中,GLY显示出可接受的长期安全性,未出现新的安全问题。它在日本COPD患者中显示出肺功能和症状控制的改善。