首页 >  专业园地 >  文献导读 >  治疗 > 正文

过敏症免疫治疗在哮喘进展中的调节作用----基于人群的队列研究结果

2020/02/11

   摘要
   背景:
过敏性哮喘的发病率很高,随哮喘的严重程度而增加,加重了公共卫生的负担。有证据表明,变态反应免疫疗法(AIT)可防止变应性鼻炎(AR)向哮喘的进展。然而,针对AIT预防从轻度哮喘发展为更严重哮喘的功效的证据尚不充分。
   方法:这项基于人群的队列研究利用了德国法定健康保险中的医疗数据(2005年至2014年)。根据全球哮喘病倡议(GINA)推荐的治疗步骤对哮喘的严重程度进行了分类。 使用针对年龄和性别进行调整的多变量Cox回归模型分析了AIT对GINA分级治疗的影响。
   结果:在总共1,739,440名患者中,有39,167名年龄在14岁或以上的人在观察期内被分类为患有哮喘并纳入研究。 从这些患者中,有4,111名患者(10.5%)接受了AIT。 应用AIT显著降低了哮喘进展的可能性,从GINA 1级到GINA 3级治疗(HR 0.87; 95%CI 0.80-0.95)和GINA 3级到GINA 4级治疗(HR 0.66; 95%CI 0.60-0.74)。GINA2级和5级治疗很少使用。
   结论:这项在真实世界中的观察性研究表明,与未接受AIT的哮喘患者相比,接受AIT的过敏性哮喘患者发生哮喘严重发作的概率更小。




( 中国医科大学附属第一医院 李文扬 摘译 杨冬 审校)
(Schmitt J et al. Allergy. 2019 Aug 13.)
 
 
 
The moderating role of allergy immunotherapy in asthma progression. Results of a population-based cohort study.
 
Schmitt J et al.  Allergy. 2019 Aug 13.

Abstract
BACKGROUND:Allergic asthma causes substantial morbidity and constitutes a public health burden, which increases with asthma severity. There is evidence that allergy immunotherapy (AIT) prevents the progression from allergic rhinitis (AR) to asthma. However, evidence is missing on the potential of AIT to prevent progression from milder to more severe asthma.
METHODS:This population-based cohort study utilized healthcare data (2005 to 2014) from a statutory health insurance in Germany. The severity of asthma was classified according to the treatment steps recommended by the global initiative for asthma (GINA). The effect of AIT on the transition between the GINA steps was analyzed using multivariable Cox regression models adjusted for age and sex.
RESULTS:From the total cohort of 1,739,440 patients, 39,167 individuals aged 14 years or older were classified as having incident asthma during the observation period and were included in the study. From these, 4,111 patients (10.5%) received AIT. AIT exposure was associated with a significantly decreased likelihood of asthma progression from GINA step 1 to GINA step 3 (HR 0.87; 95% CI 0.80-0.95) and GINA step 3 to GINA step 4 (HR 0.66; 95% CI 0.60-0.74). GINA medication for step 2 and step 5 were rarely prescribed.
CONCLUSIONS:This observational study in a real-world setting indicates that patients with allergic asthma who receive AIT are less likely to experience progression of asthma severity than asthma patients not receiving AIT.





上一篇: 哮喘和皮肤过敏的新生物治疗方法
下一篇: 成人轻中度哮喘中布地奈德-福莫特罗按需使用对比布地奈德维持治疗联合按需使用特布他林治疗(PRACTICAL):一项为期5

用户登录