Vincent Yi-Fong Su, Ting-Lin Ding, Yuh-Lih Chang, Yueh-Ching Chou, Hsuen-En Hwang, Chian-Ying Chou, Chia-Chen Hsu
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Among the 694 propensity score matched patients, ICS/LABA FDC had comparable outcomes to LAMA, with HRs of 1.22 (95% CI 0.81-1.83) for hospitalized respiratory infection, 1.06 (95% CI 0.84-1.33) for acute exacerbation, and 1.06 (95% CI 0.66-1.02) for all-cause hospitalization. Beclomethasone/formoterol (BEC/FOR) or budesonide/formoterol (BUD/FOR) led to a lower risk of acute exacerbation compared to fluticasone/salmeterol (FLU/SAL) (BEC/FOR HR 0.59, 95% CI 0.43-0.81; BUD/FOR HR 0.68, 95% CI 0.50-0.93). BEC/FOR resulted in lower risks of hospitalized respiratory infection (HR 0.48, 95% 0.26-0.86) and all-cause hospitalization (HR 0.55, 95% 0.37-0.80) compared to FLU/SAL.</p><p><strong>Conclusion: </strong>Our findings provide important evidence on the effectiveness and safety of ICS/LABA FDC compared with LAMA for bronchiectasis. BEC/FOR and BUD/FOR were associated with better outcomes than FLU/SAL.</p>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative effectiveness and safety of inhaled corticosteroid plus long-acting β<sub>2</sub>-agonist fixed-dose combinations vs. long-acting muscarinic antagonist in bronchiectasis.\",\"authors\":\"Vincent Yi-Fong Su, Ting-Lin Ding, Yuh-Lih Chang, Yueh-Ching Chou, Hsuen-En Hwang, Chian-Ying Chou, Chia-Chen Hsu\",\"doi\":\"10.1080/17512433.2024.2306218\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This study aimed to evaluate the effectiveness and safety of fixed-dose combination (FDC) inhaled corticosteroids/long-acting β<sub>2</sub>-agonists (ICS/LABA) in bronchiectasis.</p><p><strong>Research design and methods: </strong>A retrospective cohort study analyzed electronic medical records of bronchiectasis patients initiating ICS/LABA FDC or LAMA between 2007 and 2021. All bronchiectasis diagnoses were made by radiologists using high-resolution computed tomography.</p><p><strong>Results: </strong>Of the 1,736 patients, 1,281 took ICS/LABA FDC and 455 LAMA. Among the 694 propensity score matched patients, ICS/LABA FDC had comparable outcomes to LAMA, with HRs of 1.22 (95% CI 0.81-1.83) for hospitalized respiratory infection, 1.06 (95% CI 0.84-1.33) for acute exacerbation, and 1.06 (95% CI 0.66-1.02) for all-cause hospitalization. Beclomethasone/formoterol (BEC/FOR) or budesonide/formoterol (BUD/FOR) led to a lower risk of acute exacerbation compared to fluticasone/salmeterol (FLU/SAL) (BEC/FOR HR 0.59, 95% CI 0.43-0.81; BUD/FOR HR 0.68, 95% CI 0.50-0.93). BEC/FOR resulted in lower risks of hospitalized respiratory infection (HR 0.48, 95% 0.26-0.86) and all-cause hospitalization (HR 0.55, 95% 0.37-0.80) compared to FLU/SAL.</p><p><strong>Conclusion: </strong>Our findings provide important evidence on the effectiveness and safety of ICS/LABA FDC compared with LAMA for bronchiectasis. 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引用次数: 0
摘要
研究背景本研究旨在评估固定剂量联合（FDC）吸入皮质类固醇/长效β2-受体激动剂（ICS/LABA）治疗支气管扩张症的有效性和安全性：一项回顾性队列研究分析了2007年至2021年间开始使用ICS/LABA FDC或LAMA的支气管扩张症患者的电子病历。所有支气管扩张症的诊断均由放射科医生使用高分辨率计算机断层扫描做出：在1736名患者中，1281人服用了ICS/LABA FDC，455人服用了LAMA。在 694 名倾向评分匹配的患者中，ICS/LABA FDC 的疗效与 LAMA 相当，住院呼吸道感染的 HR 值为 1.22（95% CI 0.81-1.83），急性加重的 HR 值为 1.06（95% CI 0.84-1.33），全因住院的 HR 值为 1.06（95% CI 0.66-1.02）。与氟替卡松/沙美特罗（FLU/SAL）相比，倍氯米松/福莫特罗（BEC/FOR）或布地奈德/福莫特罗（BUD/FOR）导致急性加重的风险较低（BEC/FOR HR 0.59，95% CI 0.43-0.81；BUD/FOR HR 0.68，95% CI 0.50-0.93）。与 FLU/SAL 相比，BEC/FOR 可降低呼吸道感染住院风险（HR 0.48，95% 0.26-0.86）和全因住院风险（HR 0.55，95% 0.37-0.80）：我们的研究结果为ICS/LABA FDC与LAMA相比治疗支气管扩张症的有效性和安全性提供了重要证据。BEC/FOR和BUD/FOR的疗效优于FLU/SAL。
Comparative effectiveness and safety of inhaled corticosteroid plus long-acting β2-agonist fixed-dose combinations vs. long-acting muscarinic antagonist in bronchiectasis.
Background: This study aimed to evaluate the effectiveness and safety of fixed-dose combination (FDC) inhaled corticosteroids/long-acting β2-agonists (ICS/LABA) in bronchiectasis.
Research design and methods: A retrospective cohort study analyzed electronic medical records of bronchiectasis patients initiating ICS/LABA FDC or LAMA between 2007 and 2021. All bronchiectasis diagnoses were made by radiologists using high-resolution computed tomography.
Results: Of the 1,736 patients, 1,281 took ICS/LABA FDC and 455 LAMA. Among the 694 propensity score matched patients, ICS/LABA FDC had comparable outcomes to LAMA, with HRs of 1.22 (95% CI 0.81-1.83) for hospitalized respiratory infection, 1.06 (95% CI 0.84-1.33) for acute exacerbation, and 1.06 (95% CI 0.66-1.02) for all-cause hospitalization. Beclomethasone/formoterol (BEC/FOR) or budesonide/formoterol (BUD/FOR) led to a lower risk of acute exacerbation compared to fluticasone/salmeterol (FLU/SAL) (BEC/FOR HR 0.59, 95% CI 0.43-0.81; BUD/FOR HR 0.68, 95% CI 0.50-0.93). BEC/FOR resulted in lower risks of hospitalized respiratory infection (HR 0.48, 95% 0.26-0.86) and all-cause hospitalization (HR 0.55, 95% 0.37-0.80) compared to FLU/SAL.
Conclusion: Our findings provide important evidence on the effectiveness and safety of ICS/LABA FDC compared with LAMA for bronchiectasis. BEC/FOR and BUD/FOR were associated with better outcomes than FLU/SAL.
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