Real-World Effectiveness of Single-Inhaler Triple Therapy for COPD: Impact of Diabetes Comorbidity.

IF 2.2 4区医学 Q3 RESPIRATORY SYSTEM

COPD: Journal of Chronic Obstructive Pulmonary Disease Pub Date : 2024-12-01 Epub Date: 2024-03-20 DOI:10.1080/15412555.2024.2327345

Sophia Eilat-Tsanani, Pierre Ernst, Samy Suissa

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Abstract

Type 2 diabetes is a frequent comorbidity in chronic obstructive pulmonary disease (COPD) patients, with the GOLD treatment recommendations asserting that the presence of diabetes be disregarded in the choice of treatment.

In a cohort of COPD patients with frequent exacerbations, initiators of single-inhaler triple therapy or dual bronchodilators were compared on the incidence of COPD exacerbation and pneumonia over one year, adjusted by propensity score weighting and stratified by type 2 diabetes.

The COPD cohort included 1,114 initiators of triple inhalers and 4,233 of dual bronchodilators (28% with type 2 diabetes). The adjusted hazard ratio (HR) of exacerbation with triple therapy was 1.04 (95% CI: 0.86-1.25) among COPD patients with type 2 diabetes and 0.74 (0.65-0.85) in those without. The incidence of severe pneumonia was elevated with triple therapy among patients with type 2 diabetes (HR 1.77; 1.14-2.75).

Triple therapy in COPD is effective among those without, but not those with, type 2 diabetes. Future therapeutic trials in COPD should consider diabetes comorbidity.

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单吸入器三联疗法治疗慢性阻塞性肺病的实际效果：糖尿病并发症的影响。

2 型糖尿病是慢性阻塞性肺病（COPD）患者的常见合并症，GOLD 治疗建议主张在选择治疗方法时不考虑糖尿病的存在。在一组频繁恶化的慢性阻塞性肺病患者中，对开始使用单吸入剂三联疗法或双支气管扩张剂的患者一年内慢性阻塞性肺病恶化和肺炎的发生率进行了比较，并根据倾向得分加权法进行了调整，同时按2型糖尿病进行了分层。在接受三联疗法的慢性阻塞性肺病患者中，2型糖尿病患者病情加重的调整后危险比（HR）为1.04（95% CI：0.86-1.25），非2型糖尿病患者为0.74（0.65-0.85）。2型糖尿病患者接受三联疗法后，重症肺炎的发病率升高（HR 1.77；1.14-2.75）。未来的慢性阻塞性肺病治疗试验应考虑糖尿病合并症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

COPD: Journal of Chronic Obstructive Pulmonary Disease RESPIRATORY SYSTEM-

CiteScore

4.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： From pathophysiology and cell biology to pharmacology and psychosocial impact, COPD: Journal Of Chronic Obstructive Pulmonary Disease publishes a wide range of original research, reviews, case studies, and conference proceedings to promote advances in the pathophysiology, diagnosis, management, and control of lung and airway disease and inflammation - providing a unique forum for the discussion, design, and evaluation of more efficient and effective strategies in patient care.