日本严重哮喘患者的流行病学:一项全国性描述性研究

Yuya Kimura, M. Suzukawa, T. Jo, Yohei Hashimoto, R. Kumazawa, M. Ishimaru, H. Matsui, A. Yokoyama, Goh Tanaka, Hideo Yasunaga
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摘要

欧洲呼吸学会和美国胸科学会的指南根据治疗强度对重症哮喘进行了定义,并估计重症哮喘在所有哮喘病例中所占比例为 5-10%。然而,支持这一估计的数据以及有关哮喘病例的全面和连续数据却很少。我们利用覆盖率≥99%的日本全国行政数据库,评估了2013年、2015年、2017年和2019年重症哮喘的患病率和比例。此外,我们还阐明了哮喘患者的人口统计学特征、治疗方法和结果。2019年,全国轻度-中度和重度哮喘的患病率分别为每10万人中有800人和36人。在研究年份中,轻中度哮喘的发病率几乎保持不变,但重度哮喘的发病率有所下降,导致重度哮喘的比例从 5.6% 降至 4.3%。虽然治疗方式有所发展,如更多地使用联合吸入器和哮喘生物制剂,但仍有约 15%的轻中度哮喘和 45%的重度哮喘病例被视为 "未受控制"。在轻度-中度和重度哮喘患者中,死于哮喘的人数都有所下降。这项研究显示,重度哮喘的发病率在研究期间有所下降,在最新数据中低于 5%。尽管治疗方法在不断改进,但仍有相当一部分轻中度和重度哮喘患者的哮喘控制情况不佳。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Epidemiology of patients with severe asthma in Japan: a nationwide descriptive study
The European Respiratory Society and the American Thoracic Society guideline defined severe asthma based on treatment intensity and estimated the proportion of severe asthma among all asthma cases to be 5–10%. However, data supporting the estimate and comprehensive and sequential data on asthma cases are scarce. We aimed to estimate the national prevalence and proportion of severe asthma during the last decade.Using a Japanese national administrative database, which covers ≥99% of the population, we evaluated the prevalence and proportion of severe asthma in 2013, 2015, 2017, and 2019. Additionally, we elucidated the demographic characteristics, treatments, and outcomes of patients with asthma.The national prevalence of mild–moderate and severe asthma in 2019 was 800 and 36 per 100 000 persons, respectively. While the prevalence of mild–moderate asthma remained almost constant in the study years, the prevalence of severe asthma decreased, resulting in a reduction in the proportion of severe asthma from 5.6% to 4.3%. Although treatment modalities have evolved, such as the increased use of combination inhalers and asthma biologics, approximately 15% of mild–moderate and 45% of severe asthma cases were still considered “uncontrolled”. The number of deaths from asthma decreased in patients with both mild–moderate and severe asthma.This study revealed that the prevalence of severe asthma decreased during the study period and fell below 5% in the most recent data. Despite treatment evolution, a substantial proportion of patients with both mild–moderate and severe asthma still have poor asthma control.
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