在轻度间歇性（1级）哮喘患儿中按需单独使用短效β2受体激动剂与按需使用短效β2受体激动剂加吸入性皮质类固醇：一项成本效益
2022/03/17
在轻度间歇性（1级）哮喘患儿中按需单独使用短效β2受体激动剂与按需使用短效β2受体激动剂加吸入性皮质类固醇：一项成本效益分析
摘要
背景：尽管按需使用短效β2受体激动剂（SABA）加吸入性皮质类固醇（ICS）治疗儿童轻度间歇性哮喘的疗效已被证明，但其成本效益的证据尚不多见。
目的：本研究的目的是比较5-11岁轻度间歇性（1级）哮喘但正遭受哮喘症状加重的儿童在按需单独使用SABA与按需使用SABA加ICS的成本效益。
方法：采用决策分析模型。有效性参数来自随机临床试验。成本数据来自医院账单和哥伦比亚国家药品价格手册。这项研究是从哥伦比亚国家医疗体系的角度进行的。该模型的主要结果是哮喘加重（AE）导致的第一个疗程的强的松治疗。
结果：与单独使用SABA相比，按需使用SABA加ICS与较低的总体治疗成本（17.99美元对27.94美元平均每位患者成本）和较高的不需要第一疗程强的松的概率（0.6500对0.5100）相关，因此显示出优势。
结论：在哥伦比亚，与单独使用沙丁胺醇相比，按需使用沙丁胺醇加丙酸倍氯米松以缓解症状对5-11岁轻度间歇性（1级）哮喘儿童具有成本效益，因为在较低的总治疗成本下，AE患者不需要强的松治疗的可能性更高。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2022 Mar 5;S2213-2198(22)00223-9. doi: 10.1016/j.jaip.2022.02.022.)
(J Allergy Clin Immunol Pract. 2022 Mar 5;S2213-2198(22)00223-9. doi: 10.1016/j.jaip.2022.02.022.)
As-needed use of short-acting β2-agonists alone versus as-needed use of short-acting β2-agonists plus inhaled corticosteroids in pediatric patients with mild intermittent (step-1) asthma: a cost-effectiveness analysis
Carlos E Rodriguez-Martinez, Monica P Sossa-Briceño, Jefferson Antonio Buendia
Abstract
Background：Although the efficacy of the as-needed use of short-acting β2-agonist (SABAs) plus inhaled corticosteroids (ICS) for treating children with mild intermittent asthma has been demonstrated, evidence of its cost-effectiveness is scarce.
Objectives：The aim of the present study was to compare the cost-effectiveness of the as-needed use of SABAs alone versus the as-needed use of SABAs plus ICS in children 5-11 years old with mild intermittent (step-1) asthma but suffering from an exacerbation of asthma symptoms.
Methods：A decision-analysis model was adapted. Effectiveness parameters were obtained from a randomized clinical trial. Cost data were obtained from hospital bills and from the national manual of drug prices in Colombia. The study was carried out from the perspective of the national healthcare system in Colombia. The main outcome of the model was a first course of prednisone for an asthma exacerbation (AE).
Results：Compared to the use of SABAs alone, the as-needed use of SABAs plus ICS was associated with lower overall treatment costs (US$17.99 vs. US$27.94 mean cost per patient) and a higher probability of a lack of a requirement for a first course of prednisone (0.6500 vs. 0.5100), thus showing dominance.
Conclusions：In Colombia, compared to the use of albuterol alone, the use of beclomethasone dipropionate added to albuterol as needed for symptom relief is cost-effective in children 5-11 years old with mild intermittent (step-1) asthma, because it involves a higher probability of a lack of a requirement for prednisone for AE at lower total treatment costs.
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Dupilumab减少糖皮质激素依赖严重哮喘患者口服糖皮质激素的使用:一项3期、开放性扩展TRAVERSE试验的研究
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tezepelumab在严重哮喘中的基线2型生物标志物水平和反应
