使用植物花粉片剂进行免疫治疗可减少过敏性鼻炎和哮喘的药物使用：一项来自法国的回顾性数据库研究
2020/01/02
摘要
背景：中重度过敏性鼻炎（AR）可能增加哮喘发展或恶化的风险，而采用皮下或舌下过敏原免疫疗法（SLIT）治疗AR可能会减缓该进程。
方法：在回顾性实际分析中，我们从法国零售药店处收集了在2012年3月1日至2016年12月31日之间的处方执行情况，并使用线性回归分析的方法将至少连续两年中接受过至少两次草花粉SLIT药片处方的患者与仅接受对症药物治疗的对照组患者进行比较。
结果：我们在主题分析中涵盖了1,099名SLIT患者和27,475名对照组患者。在有症状的AR药物配药中，我们观察到前指数/随访率在SLIT组中下降了50％，在年龄未匹配的对照组中增加了30％（p <0.0001 vs. SLIT），而在年龄匹配的对照组中则增加了20％（p <0.0001 vs.SLLIT）。在随访期间，SLIT组中有11人（1.8％）需要哮喘治疗，而在对照组中则有782人（5.3％）。SLIT组中使用新发哮喘药物的相对几率较低（年龄未匹配组的62.5％[29.1％; 80.1％],p = 0.0025; 年龄匹配组的63.7％[31.5％; 80.7％],p= 0.0018）。与对照组相比，SLIT还与随访期间较缓慢的哮喘药物使用进展相关（与年龄未匹配组相比：回归系数= -0.58 [-0.74; -0.42]，p <0.0001；与年龄匹配组相比：回归系数= -0.61 [-0.76; -0.46]，p <0.0001）。
结论：草花粉SLIT片的处方减少了生活中AR和哮喘药物的使用。
Immunotherapy with grass pollen tablets reduces medication dispensing for
allergic rhinitis and asthma: a retrospective database study in France.
Devillier P, et al. Allergy. 2018 Dec 27.
Abstract
Background ：Moderate-to-severe allergic rhinitis (AR) may increase the risk of developing or worsening asthma, whereas treatment of AR with subcutaneously or sublingual allergen immunotherapy (SLIT) may slow this progression.
Methods： In a retrospective real-world analysis, prescription fulfilment data were gathered from French retail pharmacies between March 1st , 2012, and December 31st , 2016. Using linear regression analyses, patients having received at least two prescriptions of grass pollen SLIT tablets over at least two successive years were compared with control patients having received symptomatic medications only.
Results： 1,099 SLIT patients and 27,475 control patients were included in the main analysis. With regard to symptomatic AR medication dispensing, we observed a 50% decrease in the pre-index/follow-up ratio in the SLIT group, a 30% increase in the control group without age matching (p<0.0001 vs. SLIT), and a 20% increase in the control group with age matching (p<0.0001 vs. SLIT). During the follow-up,11 (1.8%) and 782 (5.3%) patients initiated asthma treatment in the SLIT and control groups, respectively. The relative risk of medication dispensing for new asthma was lower in the SLIT group (by 62.5% [29.1%;80.1%] without age matching (p=0.0025), and by 63.7% [31.5%;80.7%] with age matching (p=0.0018)). SLIT was also associated with slower progression of asthma medication dispensing during the follow-up period, relative to the control group (regression coefficient:-0.58[-0.74;-0.42] without age matching (p<0.0001) and -0.61 [-0.76;-0.46] with age matching (p<0.0001)).
Conclusion ：Prescription of grass pollen SLIT tablets reduced the dispensing of AR and asthma medications in real life.
背景：中重度过敏性鼻炎（AR）可能增加哮喘发展或恶化的风险，而采用皮下或舌下过敏原免疫疗法（SLIT）治疗AR可能会减缓该进程。
方法：在回顾性实际分析中，我们从法国零售药店处收集了在2012年3月1日至2016年12月31日之间的处方执行情况，并使用线性回归分析的方法将至少连续两年中接受过至少两次草花粉SLIT药片处方的患者与仅接受对症药物治疗的对照组患者进行比较。
结果：我们在主题分析中涵盖了1,099名SLIT患者和27,475名对照组患者。在有症状的AR药物配药中，我们观察到前指数/随访率在SLIT组中下降了50％，在年龄未匹配的对照组中增加了30％（p <0.0001 vs. SLIT），而在年龄匹配的对照组中则增加了20％（p <0.0001 vs.SLLIT）。在随访期间，SLIT组中有11人（1.8％）需要哮喘治疗，而在对照组中则有782人（5.3％）。SLIT组中使用新发哮喘药物的相对几率较低（年龄未匹配组的62.5％[29.1％; 80.1％],p = 0.0025; 年龄匹配组的63.7％[31.5％; 80.7％],p= 0.0018）。与对照组相比，SLIT还与随访期间较缓慢的哮喘药物使用进展相关（与年龄未匹配组相比：回归系数= -0.58 [-0.74; -0.42]，p <0.0001；与年龄匹配组相比：回归系数= -0.61 [-0.76; -0.46]，p <0.0001）。
结论：草花粉SLIT片的处方减少了生活中AR和哮喘药物的使用。
(中国医科大学附属一院呼吸与危重症学科 李文扬 摘译 杨冬 审校)
(Devillier P, et al. Allergy. 2018 Dec 27.)
(Devillier P, et al. Allergy. 2018 Dec 27.)
Immunotherapy with grass pollen tablets reduces medication dispensing for
allergic rhinitis and asthma: a retrospective database study in France.
Devillier P, et al. Allergy. 2018 Dec 27.
Abstract
Background ：Moderate-to-severe allergic rhinitis (AR) may increase the risk of developing or worsening asthma, whereas treatment of AR with subcutaneously or sublingual allergen immunotherapy (SLIT) may slow this progression.
Methods： In a retrospective real-world analysis, prescription fulfilment data were gathered from French retail pharmacies between March 1st , 2012, and December 31st , 2016. Using linear regression analyses, patients having received at least two prescriptions of grass pollen SLIT tablets over at least two successive years were compared with control patients having received symptomatic medications only.
Results： 1,099 SLIT patients and 27,475 control patients were included in the main analysis. With regard to symptomatic AR medication dispensing, we observed a 50% decrease in the pre-index/follow-up ratio in the SLIT group, a 30% increase in the control group without age matching (p<0.0001 vs. SLIT), and a 20% increase in the control group with age matching (p<0.0001 vs. SLIT). During the follow-up,11 (1.8%) and 782 (5.3%) patients initiated asthma treatment in the SLIT and control groups, respectively. The relative risk of medication dispensing for new asthma was lower in the SLIT group (by 62.5% [29.1%;80.1%] without age matching (p=0.0025), and by 63.7% [31.5%;80.7%] with age matching (p=0.0018)). SLIT was also associated with slower progression of asthma medication dispensing during the follow-up period, relative to the control group (regression coefficient:-0.58[-0.74;-0.42] without age matching (p<0.0001) and -0.61 [-0.76;-0.46] with age matching (p<0.0001)).
Conclusion ：Prescription of grass pollen SLIT tablets reduced the dispensing of AR and asthma medications in real life.
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严重哮喘的随机对照试验：通过表型或定型进行选择
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哮喘和 COPD 患者吸入药物的使用和吸入技术：一项随机对照试验数据
