长效β激动剂对慢性阻塞性肺疾病患者肺癌进展风险的影响：一项全国性队列研究

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY

Pharmacoepidemiology and Drug Safety Pub Date : 2025-09-01 DOI:10.1002/pds.70204

Shih-Hsun Lin, Yu-Chun Lin, Tsai-Hui Lin, Hung-Jen Lin, Mei-Chen Lin, Sheng-Teng Huang

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引用次数: 0

摘要

目的：慢性阻塞性肺疾病（COPD）是肺癌致残的常见合并症。长效β2激动剂（LABA）通常用于中度至极重度COPD患者。本研究旨在利用全国代表性数据库评估LABA治疗与COPD患者肺癌风险之间的关系。方法：我们使用纵向健康保险数据库进行分析。从1997年到2012年，因COPD诊断至少两次门诊就诊或一次住院的患者（ICD-9-CM: 491,492,494,496）被确定。LABA队列患者在研究期间定期使用LABA，而非LABA队列为未接受LABA治疗的患者。采用1:2倾向评分匹配COPD诊断年、指标年、性别、年龄、职业、合并症和用药情况。结果：共有3924例COPD患者入组，其中常规LABA治疗1308例，未进行LABA治疗2616例。大约一半的研究对象为男性（54.8%），平均年龄为63.1岁。接受LABA治疗的男性（aHR = 2.15, 95% CI = 1.09-4.22）患肺癌的风险增加。结论：本研究提示，老年男性COPD患者LABA治疗与肺癌相关；那些每日累积剂量高的人。

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Impact of Long-Acting Beta-Agonists on Progressive Risk of Lung Cancer in Patients With Chronic Obstructive Pulmonary Disease: A Nationwide Cohort Study.

Purpose: Chronic obstructive lung disease (COPD) is a common comorbid disease in lung cancer causing disability. A long-acting β2-agonist (LABA) is commonly given to patients with moderate to very severe COPD. This study aims to evaluate the relationship between LABA treatment and the risk of lung cancer in patients with COPD using a national representative database.

Methods: We conducted the analyses using the Longitudinal Health Insurance Database. Patients with at least two outpatient visits or one hospitalization due to COPD diagnosis (ICD-9-CM: 491, 492, 494, 496) from 1997 to 2012 were identified. Patients in the LABA cohort had regularly used LABA during the study period, while the non-LABA cohort was those without receiving LABA treatment. A 1:2 propensity score matching by COPD diagnosis year, index year, sex, age, occupation, comorbidities, and medication usage was applied.

Results: A total of 3924 patients with COPD were enrolled in the study, 1308 patients with regular LABA treatment and 2616 patients without LABA treatment. Approximately half of the study subjects were male (54.8%), with a mean age of 63.1 years. Those with LABA treatment who were male (aHR = 2.15, 95% CI = 1.09-4.22) had an increased risk of lung cancer.

Conclusions: This study indicated that LABA treatment in patients with COPD was associated with lung cancer in older men; those with high cumulative daily doses.

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来源期刊

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.