重度哮喘患者接受生物制剂及持续控制不足相关因素的改善:一项真实的国家研究。

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
Laurent Guilleminault, Claire Camus, Chantal Raherison-Semjen, Audrey Capdepon, Arnaud Bourdin, Philippe Bonniaud, Stéphanie Fry, Gilles Devouassoux, François-Xavier Blanc, Christophe Pison, Clairelyne Dupin, Naji Khayath, Joelle Courdeau, Judith Valcke-Brossollet, Cécilia Nocent-Ejnaini, Fabien Rolland, Carmen Lamandi, Alain Proust, Anaig Ozier, Laurent Portel, Wanda Gaspard, Pauline Roux-Claude, Antoine Beurnier, Stéphanie Martinez, Jean-Marc Dot, Florence Hennegrave, Guillaume Vignal, Etienne Auvray, Nicolas Paleiron, Nicolas Just, Jean Miltgen, Maud Russier, Cécile Olivier, Camille Taillé, Alain Didier
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引用次数: 0

摘要

背景:生物疗法已经彻底改变了重症哮喘伴2型炎症的治疗。尽管这些治疗方法在减少病情恶化和口服类固醇剂量方面非常有效,但对使用生物制剂治疗的严重哮喘患者的症状持续性知之甚少。目的:探讨生物制剂治疗重症哮喘患者的哮喘控制和医疗消费情况。设计:第二项舒芙蕾研究是一项由严重哮喘临床研究倡议:创新与科学网络杠杆批准的现实前瞻性观察研究。方法:确诊为严重哮喘至少持续12个月的成年人被纳入研究。对患者进行哮喘控制问卷(ACQ)、哮喘生活质量问卷(AQLQ)及依从性评价测试。记录入组前12个月内的医疗消费情况。在接受生物制剂的患者中,医生指出患者是否有生物反应或无反应。结果:对431例重症哮喘患者的特点进行了分析。其中409例(94.9%)哮喘伴2型炎症(T2高),297例(72.6%)T2高表型患者接受了生物制剂治疗。医生估计接受生物制剂的患者中有88.2%是有反应的。然而,只有25.3%的患者哮喘得到控制(ACQ > 0.75)。高比例(77.8%)的患者被确定为对生物制剂有反应,但未根据ACQ评分进行控制。约50%的患者继续每日口服皮质类固醇(25.2%)或每年至少连续三天使用三次以上(25.6%)。胃食管反流病(GERD)和阻塞性睡眠呼吸暂停综合征(OSA)被确定为与未控制哮喘相关的独立因素。结论:虽然对生物制剂有反应的重症哮喘患者比例很高,但哮喘得到控制的患者仅占25.3%。胃食管反流和呼吸暂停是哮喘不受控制的独立因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improvement in severe asthma patients receiving biologics and factors associated with persistent insufficient control: a real-life national study.

Background: Biological therapies have revolutionized the treatment of severe asthma with type 2 inflammation. Although such treatments are very effective in reducing exacerbation and the dose of oral steroids, little is known about the persistence of symptoms in severe asthma patients treated with biologics.

Purpose: We aim to describe asthma control and healthcare consumption of severe asthma patients treated with biologics.

Design: The Second Souffle study is a real-life prospective observational study endorsed by the Clinical Research Initiative in Severe Asthma: a Lever for Innovation & Science Network.

Methods: Adults with a confirmed diagnosis of severe asthma for at least 12 months' duration were enrolled in the study. A self-administered questionnaire including the Asthma Control Questionnaire (ACQ), Asthma Quality of Life Questionnaire (AQLQ) and a compliance evaluation test was given to the patients. Healthcare consumption within 12 months prior to enrolment was documented. In patients receiving biologics, doctors indicated whether the patients were biologic responders or non-responders.

Results: The characteristics of 431 patients with severe asthma were analysed. Among them, 409 patients (94.9%) presented asthma with type 2 inflammation (T2 high) profile, and 297 (72.6%) patients with a T2 high phenotype were treated with a biologic. Physicians estimated that 88.2% of patients receiving biologics were responders. However, asthma control was only achieved in 25.3% of those patients (ACQ > 0.75). A high proportion of patients (77.8%) identified as responders to biologics were not controlled according to the ACQ score. About 50% of patients continue to use oral corticosteroids either daily (25.2%) or more than three times a year for at least three consecutive days (25.6%). Gastro-oesophageal Reflux Disease (GERD) and Obstructive Sleep Apnoea syndrome (OSA) were identified as independent factors associated with uncontrolled asthma.

Conclusion: Although a high proportion of severe asthma patients respond to biologics, only 25.3% have controlled asthma. GERD and OSA are independent factors of uncontrolled asthma.

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