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美国专科治疗的重度哮喘患者使用生物制剂起始治疗后的生活质量改善情况

Quality of Life Improvements with Biologic Initiation Among Subspecialist-Treated US Patients with Severe Asthma.

作者信息

Soong Weily, Chipps Bradley E, Carr Warner, Trevor Jennifer, Patel Arpan, Clarke Nicole, Carstens Donna D, Ambrose Christopher S

机构信息

AllerVie Health, AllerVie Clinical Research, Birmingham, AL, USA.

Capital Allergy & Respiratory Disease Center, Sacramento, CA, USA.

出版信息

J Asthma Allergy. 2024 May 10;17:441-448. doi: 10.2147/JAA.S452386. eCollection 2024.

Abstract

PURPOSE

Patients living with severe asthma (SA) experience multiple health-related quality of life (HRQoL) impairments. This study examined HRQoL changes after biologic treatment initiation among a large, real-world cohort of patients with SA.

PATIENTS AND METHODS

CHRONICLE is an ongoing observational study of subspecialist-treated adults with SA who receive biologics or maintenance systemic corticosteroids or are uncontrolled on high-dosage inhaled corticosteroids with additional controllers. Patients enrolled February 2018-February 2023 were asked to complete the St. George's Respiratory Questionnaire (SGRQ) every 6 months (total score range of 0-100 [0=best possible health], meaningful change threshold is a 4-unit reduction in the total score). Changes in SGRQ responses from 6 months before initiation to 12 to 18 months after initiation were summarized.

RESULTS

A total of 76 patients completed the SGRQ 0 to 6 months before and 12 to 18 months after biologic initiation. The mean (SD) SGRQ total score decreased from 52.2 (20.6) to 41.9 (23.8), with improvement across the symptoms (-14.5), activity (-11.0), and impacts (-8.3) components. For specific impairments reported by ≥50% of patients before biologic initiation, fewer reported each impairment after biologic initiation; the largest reductions were for "Questions about what activities usually make you feel short of breath these days [Walking outside on level ground]" (67% to 43%), "Questions about other effects that your respiratory problems may have on you these days [I feel that I am not in control of my respiratory problems]" (55% to 34%), and "Questions about your cough and shortness of breath these days [My coughing or breathing disturbs my sleep]" (63% to 45%).

CONCLUSION

In this real-world cohort of adults with SA, biologic initiation was associated with meaningful improvements in asthma-related HRQoL. These data provide further insight into the burden SA places on patients and the benefits of biologic treatment.

摘要

目的

重度哮喘(SA)患者存在多种与健康相关的生活质量(HRQoL)损害。本研究在一个大型的、真实世界的SA患者队列中,考察了生物制剂治疗开始后HRQoL的变化。

患者与方法

CHRONICLE是一项正在进行的观察性研究,研究对象为接受专科治疗的成年SA患者,这些患者接受生物制剂或维持性全身糖皮质激素治疗,或在高剂量吸入糖皮质激素联合其他控制药物治疗下仍未得到控制。纳入2018年2月至2023年2月的患者被要求每6个月完成一次圣乔治呼吸问卷(SGRQ)(总分范围为0至100分[0 = 最佳健康状态],有意义的变化阈值是总分降低4分)。总结了从开始治疗前6个月到开始治疗后12至18个月SGRQ回答的变化。

结果

共有76名患者在生物制剂开始治疗前0至6个月以及开始治疗后12至18个月完成了SGRQ。SGRQ总分均值(标准差)从52.2(20.6)降至41.9(23.8),症状(-14.5)、活动(-11.0)和影响(-8.3)三个分量表均有改善。对于生物制剂开始治疗前≥50%的患者报告的特定损害,生物制剂开始治疗后报告每种损害的患者减少;减少幅度最大的是 “关于这些天哪些活动通常会让你感到气短的问题[在平地上外出散步]”(从67%降至43%)、“关于这些天你的呼吸问题可能对你产生的其他影响的问题[我觉得我无法控制我的呼吸问题]”(从55%降至34%)以及“关于这些天你的咳嗽和气短的问题[我的咳嗽或呼吸干扰我的睡眠]”(从63%降至45%)。

结论

在这个真实世界的成年SA患者队列中,开始使用生物制剂与哮喘相关的HRQoL有意义的改善相关。这些数据进一步揭示了SA给患者带来的负担以及生物制剂治疗的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d66/11093117/38a37c08c943/JAA-17-441-g0001.jpg

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