确定使用ICS/LABA的哮喘患者的可治疗特征：英国的描述性分析数据库研究。

IF 4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Therapy Pub Date : 2025-08-19 DOI:10.1007/s12325-025-03332-2

Jennifer K. Quint, Adrian Rendon, Richard Stanford, Bilun Gemicioglu, Leandro Fritscher, Watchara Boonsawat, Elke Rottier, Anurita Majumdar, Mohamed Hamouda

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引用次数: 0

摘要

简介：我们的目的是了解中至重度哮喘发作的预测因素和每日两次吸入皮质类固醇/长效β2激动剂（ICS/LABAs）在英国成人哮喘患者中使用的高短效β2激动剂（SABA）。方法：这项非介入性、纵向、回顾性研究使用了英国的医疗记录数据（临床实践研究数据链Aurum；医院事件统计）。符合条件的哮喘患者在首次观察到的ICS/LABA处方日期（2017年12月1日- 2019年3月31日）前12个月年龄≥18岁。在12个月的随访中，根据中重度恶化的发生率和SABA的使用情况对患者进行分层。研究结果包括急性发作发生率和SABA使用情况。潜在类聚类（LCC）分析从随机森林分析中识别出具有高重要性（≥0.70）的预测因子聚类，并确认其临床相关性。在每个组内描述处理特征。结果：23,567例符合研究标准的患者中，白人和女性居多（80.4%）（60.3%）；平均指标年龄为50.0岁。总体而言，21个变量被区分为中度至重度加重的关键预测因子（主要预测因子：共病性心脏病、糖尿病、抑郁、吸烟、体重指数[BMI]）， 22个变量被区分为高SABA使用的关键预测因子（主要预测因子：共病性上呼吸道感染、心脏病、既往SABA使用、年龄、性别）。在经历急性发作和未经历急性发作的患者中分别观察到五组。在SABA使用率较高或较低的患者中，分别观察到5组和6组。治疗特征在不同组间相似。讨论：本研究区分了可治疗和不可治疗的恶化预测因素和高SABA使用。通过LCC分析检测到不同的哮喘表型。包括合并症、吸烟状况和BMI在内的可治疗特征可能是医疗保健专业人员的目标。结论：我们的研究结果强调了个性化哮喘治疗的重要性，以改善临床结果。

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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Identifying Treatable Traits of Patients with Asthma Prescribed an ICS/LABA: A Descriptive Analytic Database Study in England

Introduction

We aimed to understand predictors of moderate-to-severe asthma exacerbations and high short-acting β₂-agonist (SABA) use in adults with asthma newly initiating single-inhaler twice-daily inhaled corticosteroids/long-acting β₂-agonists (ICS/LABAs) in England.

Methods

This non-interventional, longitudinal, retrospective study used medical record data (Clinical Practice Research Datalink Aurum; Hospital Episode Statistics) in England. Eligible patients with diagnosed asthma were ≥ 18 years old 12 months before the first observed single-inhaler twice-daily ICS/LABA prescription date (December 1, 2017–March 31, 2019). Patients were stratified by occurrence of moderate-to-severe exacerbation and SABA use during 12 months’ follow-up. Study outcomes included exacerbation occurrence and SABA use. Latent class cluster (LCC) analysis distinguished clusters of predictors with high importance (≥ 0.70) identified from random forest analysis and confirmed on clinical relevance. Treatment characteristics were described within each cluster.

Results

Most of 23,567 patients meeting study criteria (80.4%) were white and female (60.3%); mean index age was 50.0 years. Overall, 21 variables were distinguished as key predictors of moderate-to-severe exacerbation (top predictors: comorbid cardiac disease, diabetes, depression, smoking, body mass index [BMI]) and 22 as key predictors of high SABA use (top predictors: comorbid upper respiratory tract infection, cardiac disease, prior SABA use, age, sex). Five clusters each were observed among patients who experienced an exacerbation and those who did not. Among patients with high or lower SABA use, five and six clusters were observed, respectively. Treatment characteristics were similar across clusters.

Discussion

This study distinguished treatable and non-treatable predictors of exacerbation and high SABA use. Distinct asthma phenotypes were detected via LCC analysis. Distinguished treatable traits including comorbidities, smoking status and BMI, may be targeted by healthcare professionals.

Conclusion

Our findings reinforce the importance of personalized asthma treatments with the goal of improving clinical outcomes.

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.