• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

慢性阻塞性肺疾病（COPD）现实生活中的三联疗法：使用单一吸入器还是多个吸入器更好？

Triple Therapy in COPD in Real Life: Is It Better to Use Single or Multiple Inhalers?

作者信息

Sposato Bruno, Ricci Alberto, Lacerenza Leonardo Gianluca, Petrucci Elisa, Cresti Alberto, Baratta Pasquale, Perrella Antonio, Serafini Andrea, Scalese Marco

机构信息

Pneumology Department, Local Health Unit 'Sud-Est', 'Misericordia' Hospital, 58100 Grosseto, Italy.

Division of Pneumology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, AOU Sant'Andrea, 00189 Rome, Italy.

出版信息

J Clin Med. 2024 Oct 17;13(20):6191. doi: 10.3390/jcm13206191.

DOI:10.3390/jcm13206191
PMID:39458140
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11508507/
Abstract

Today, single-inhaler ICS/LAMA/LABA (SITT) COPD therapies are available. It is unclear whether they are more effective than multiple-device triple therapies (MITT) in improving COPD outcomes. : We retrospectively considered patients on SITT/MITT in 2019/2020 who were prescribed >7 packages of ICS/LABA/LAMA or ICS/LAMA (+LAMA). The two treatments were compared concerning systemic corticosteroids, antibiotics, salbutamol, antifungal prescriptions, and number of emergency room visits/hospitalizations (ERV/Hs). We studied 292 MITT patients (Group A) during 2019, switching to SITT in 2020, and 366 subjects (Group B) who took SITT during 2019, and 206 MITT individuals (Group C) in 2020. ICS/LABA + LAMA (MITT) package use was 8.2 ± 4.2 and 7.85 ± 4 in 2019, switching to 11.2 ± 3.2 when patients shifted to SITT in 2020 ( = 0.0001). Group A MITT package use was lower than in SITT patients in 2019 (9.31 ± 2.71, = 0.0001; Group B). Throughout 2020, Group C (10.3 ± 6.1 packs) adherence to ICS/LABA was similar to SITT adherence in Group A ( = 0.270), whereas LAMA package use (9.1 ± 5) was lower ( = 0.0038). Patients using systemic corticosteroids/antibiotics were fewer in SITT in 2020, compared to the MITT results in 2019. Subjects with fewer ERV/Hs were observed with SITT rather than with MITT. Particularly, 13.8% of patients needed ≥2 ERV/Hs when treated with SITT, whereas 19.2% needed ≥2 ERV/Hs with MITT in 2019 ( = 0.08). Multivariate analysis, adjusted for all confounding factors including treatment adherence, showed that MITT (vs. SITT) can have an increased risk of at least one ERV/H (subjects receiving MITT during 2019 passing to SITT in 2020, OR: 1.718 [1.010-2.924], = 0.046; Group A/MITT/2019 vs. Group B/SITT/2019, OR: 1.650 [0.973-3.153], = 0.056; Group C/MITT/2020 vs. Group B/SITT/2019, OR: 1.908 [1.018-3.577], = 0.044). SITT therapy may promote treatment adherence more effectively, therefore, reducing COPD exacerbations better than MITT. A possible synergistic effect of ICS/LABA/LAMA intake with a single device might be another cause of SITT's greater efficacy.

摘要

如今，单吸入器ICS/LAMA/LABA（SITT）慢性阻塞性肺疾病（COPD）治疗方案已经问世。目前尚不清楚在改善COPD治疗效果方面，它们是否比多装置三联疗法（MITT）更有效。我们回顾性研究了2019/2020年接受SITT/MITT治疗的患者，这些患者被开具了超过7包ICS/LABA/LAMA或ICS/LAMA（+LAMA）。比较了两种治疗方案在全身用糖皮质激素、抗生素、沙丁胺醇、抗真菌药物处方以及急诊就诊/住院次数（ERV/Hs）方面的差异。我们研究了292例2019年接受MITT治疗（A组）、2020年转为接受SITT治疗的患者，366例2019年接受SITT治疗的患者（B组），以及206例2020年接受MITT治疗的患者（C组）。2019年，ICS/LABA + LAMA（MITT）的用药包数为8.2±4.2和7.85±4，当患者在2020年转为接受SITT治疗时，用药包数变为11.2±3.2（P = 0.0001）。A组2019年MITT的用药包数低于2019年接受SITT治疗的患者（9.31±2.71，P = 0.0001；B组）。在整个2020年，C组（10.3±6.1包）对ICS/LABA的依从性与A组SITT的依从性相似（P = 0.270），而LAMA的用药包数（9.1±5）较低（P = 0.0038）。与2019年MITT的结果相比，2020年接受SITT治疗的患者使用全身用糖皮质激素/抗生素的人数更少。接受SITT治疗的患者急诊就诊/住院次数较少，而非接受MITT治疗的患者。特别是，13.8%接受SITT治疗的患者需要≥2次急诊就诊/住院，而2019年接受MITT治疗的患者中有19.2%需要≥2次急诊就诊/住院（P = 0.08）。多因素分析对包括治疗依从性在内的所有混杂因素进行了校正，结果显示MITT（与SITT相比）至少有一次急诊就诊/住院的风险可能增加（2019年接受MITT治疗、2020年转为接受SITT治疗的患者，OR：1.718 [1.010 - 2.924]，P = 0.046；A组/MITT/2019年与B组/SITT/2019年相比，OR：1.650 [0.973 - 3.153]，P = 0.056；C组/MITT/2020年与B组/SITT/2019年相比，OR：1.908 [1.018 - 3.577]，P = 0.044）。因此，SITT治疗可能更有效地促进治疗依从性，从而比MITT更好地减少COPD急性加重。使用单一装置吸入ICS/LABA/LAMA可能产生的协同效应可能是SITT疗效更佳的另一个原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf1/11508507/0de6338368e9/jcm-13-06191-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf1/11508507/6d96ce65ed62/jcm-13-06191-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf1/11508507/a3caa14a1d83/jcm-13-06191-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf1/11508507/b02300e527a0/jcm-13-06191-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf1/11508507/5a9925a004e6/jcm-13-06191-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf1/11508507/34ef2ee3d1e4/jcm-13-06191-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf1/11508507/044871b3a672/jcm-13-06191-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf1/11508507/0de6338368e9/jcm-13-06191-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf1/11508507/6d96ce65ed62/jcm-13-06191-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf1/11508507/a3caa14a1d83/jcm-13-06191-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf1/11508507/b02300e527a0/jcm-13-06191-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf1/11508507/5a9925a004e6/jcm-13-06191-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf1/11508507/34ef2ee3d1e4/jcm-13-06191-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf1/11508507/044871b3a672/jcm-13-06191-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf1/11508507/0de6338368e9/jcm-13-06191-g007.jpg

相似文献

1
Triple Therapy in COPD in Real Life: Is It Better to Use Single or Multiple Inhalers?慢性阻塞性肺疾病（COPD）现实生活中的三联疗法：使用单一吸入器还是多个吸入器更好？
J Clin Med. 2024 Oct 17;13(20):6191. doi: 10.3390/jcm13206191.
2
Clinical Characteristics, Treatment Persistence, and Outcomes Among Patients With COPD Treated With Single- or Multiple-Inhaler Triple Therapy: A Retrospective Analysis in Spain.在西班牙进行的一项回顾性分析：接受单一或多种吸入器三联疗法治疗 COPD 患者的临床特征、治疗持续性和结局。
Chest. 2022 Nov;162(5):1017-1029. doi: 10.1016/j.chest.2022.06.033. Epub 2022 Jul 3.
3
Real-world characteristics of patients with asthma initiating fluticasone furoate/umeclidinium/vilanterol single-inhaler triple therapy in Japan.在日本，接受氟替卡松乌美溴铵维兰特罗单吸入器三联疗法治疗的哮喘患者的真实世界特征。
Respir Investig. 2024 Jul;62(4):685-694. doi: 10.1016/j.resinv.2024.05.011. Epub 2024 May 24.
4
Characteristics of New Users of Single- and Multiple-Inhaler Triple Therapy for COPD in Primary Care in England.英国初级医疗中单药和多药三联疗法治疗 COPD 的新使用者的特征。
Int J Chron Obstruct Pulmon Dis. 2022 Jun 22;17:1455-1466. doi: 10.2147/COPD.S338436. eCollection 2022.
5
Economic impact of implementing prescription of single-inhaler triple therapies versus current multiple-inhaler triple therapies for COPD in the Apulia Region.在普利亚地区实施单吸入器三联疗法与当前多吸入器三联疗法治疗 COPD 的经济影响。
BMC Health Serv Res. 2022 Oct 25;22(1):1283. doi: 10.1186/s12913-022-08640-9.
6
Inhaled corticosteroids with combination inhaled long-acting beta2-agonists and long-acting muscarinic antagonists for chronic obstructive pulmonary disease.吸入性皮质类固醇联合吸入长效β2-激动剂和长效抗胆碱能药物治疗慢性阻塞性肺疾病。
Cochrane Database Syst Rev. 2023 Dec 6;12(12):CD011600. doi: 10.1002/14651858.CD011600.pub3.
7
Medication adherence and persistence in chronic obstructive pulmonary disease patients receiving triple therapy in a USA commercially insured population.美国商业保险人群中接受三联疗法的慢性阻塞性肺疾病患者的药物依从性和持续性
Int J Chron Obstruct Pulmon Dis. 2019 Feb 19;14:343-352. doi: 10.2147/COPD.S184653. eCollection 2019.
8
Adherence to single inhaler triple therapy and digital inhalers in Chronic Obstructive Pulmonary Disease: a literature review and protocol for a randomized controlled trial (TRICOLON study).中文译文：《慢性阻塞性肺疾病中单一吸入器三联疗法和数字吸入器的依从性：文献回顾和一项随机对照试验方案（TRICOLON 研究）》
BMC Pulm Med. 2024 Jul 4;24(1):317. doi: 10.1186/s12890-024-03044-3.
9
The Impact of 52-Week Single Inhaler Device Triple Therapy versus Dual Therapy on the Mortality of COPD Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.52周单吸入器装置三联疗法与双联疗法对慢性阻塞性肺疾病患者死亡率的影响：一项随机对照试验的系统评价和荟萃分析
Life (Basel). 2022 Jan 25;12(2):173. doi: 10.3390/life12020173.
10
Comparative Adherence and Persistence of Single- and Multiple-Inhaler Triple Therapies Among Patients with Chronic Obstructive Pulmonary Disease in an English Real-World Primary Care Setting.在英国真实世界初级保健环境中，慢性阻塞性肺疾病患者使用单药和多药三联吸入疗法的依从性和持久性比较。
Int J Chron Obstruct Pulmon Dis. 2022 Sep 24;17:2417-2429. doi: 10.2147/COPD.S370540. eCollection 2022.

本文引用的文献

1
Impact of Medication Adherence on Emergency Department Visits in Patients with COPD in a Single Tertiary Hospital in Saudi Arabia.在沙特阿拉伯的一家单一的三级医院中，药物依从性对 COPD 患者急诊就诊的影响。
Int J Chron Obstruct Pulmon Dis. 2023 Apr 17;18:593-598. doi: 10.2147/COPD.S392946. eCollection 2023.
2
Comparison of treatment persistence, adherence, and risk of exacerbation in patients with COPD treated with single-inhaler multiple-inhaler triple therapy: A prospective observational study in China.单吸入器、多吸入器三联疗法治疗慢性阻塞性肺疾病患者的治疗持续性、依从性及急性加重风险比较：一项中国的前瞻性观察研究
Front Pharmacol. 2023 Mar 21;14:1147985. doi: 10.3389/fphar.2023.1147985. eCollection 2023.
3
Adherence to Long-Acting Inhaler Use for Initial Treatment and Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study.
长效吸入器用于慢性阻塞性肺疾病初始治疗及急性加重期的依从性：一项回顾性队列研究。
J Pers Med. 2022 Dec 15;12(12):2073. doi: 10.3390/jpm12122073.
4
Cost-effectiveness of single-inhaler triple therapy for patients with severe COPD: a systematic literature review.重度 COPD 患者采用单吸入器三联疗法的成本效益：系统文献回顾。
Expert Rev Respir Med. 2022 Oct;16(10):1067-1084. doi: 10.1080/17476348.2022.2145951. Epub 2022 Nov 16.
5
Cost-Effectiveness of Single- versus Multiple-Inhaler Triple Therapy in a UK COPD Population: The INTREPID Trial.在英国 COPD 人群中，单吸入器三联疗法与多吸入器三联疗法的成本效益：INTREPID 试验。
Int J Chron Obstruct Pulmon Dis. 2022 Oct 25;17:2745-2755. doi: 10.2147/COPD.S370577. eCollection 2022.
6
Economic impact of implementing prescription of single-inhaler triple therapies versus current multiple-inhaler triple therapies for COPD in the Apulia Region.在普利亚地区实施单吸入器三联疗法与当前多吸入器三联疗法治疗 COPD 的经济影响。
BMC Health Serv Res. 2022 Oct 25;22(1):1283. doi: 10.1186/s12913-022-08640-9.
7
Single-Inhaler Triple Therapy in Patients with Advanced COPD: Bayesian Modeling of the Healthcare Resource Utilization Data and Associated Costs from the IMPACT Trial.晚期 COPD 患者的三联单吸入治疗：IMPACT 试验的医疗资源利用数据和相关成本的贝叶斯建模。
Int J Chron Obstruct Pulmon Dis. 2022 Jul 25;17:1633-1642. doi: 10.2147/COPD.S342244. eCollection 2022.
8
Mortality, seasonal variation, and susceptibility to acute exacerbation of COPD in the pandemic year: a nationwide population study.在大流行的一年中，COPD 的死亡率、季节性变化和急性加重易感性：一项全国性人群研究。
Ther Adv Respir Dis. 2022 Jan-Dec;16:17534666221081047. doi: 10.1177/17534666221081047.
9
A Pandemic Lesson for Global Lung Diseases: Exacerbations Are Preventable.一场大流行对全球肺部疾病的教训：可以预防加重。
Am J Respir Crit Care Med. 2022 Jun 1;205(11):1271-1280. doi: 10.1164/rccm.202110-2389CI.
10
Social Distancing in Relation to Severe Exacerbations of Chronic Obstructive Pulmonary Disease: A Nationwide Semi-Experimental Study During the COVID-19 Pandemic.社会隔离与慢性阻塞性肺疾病重度恶化的关系：COVID-19 大流行期间的全国半实验研究。
Am J Epidemiol. 2022 Mar 24;191(5):874-885. doi: 10.1093/aje/kwab292.