| アブストラクト | RATIONALE: To assess the treatment progression during the 24 months following a formal diagnosis of chronic obstructive pulmonary disease (COPD) in the UK primary care setting. METHODS: A retrospective cohort of newly diagnosed COPD patients was identified in the Clinical Practice Research Datalink (CPRD) from 1/1/2008 until 31/12/2009. Maintenance therapy prescribed within the first 3 months of diagnosis and in the subsequent 3-month intervals for 24 months were analyzed. Treatment classes included long-acting beta2-agonists (LABAs), long-acting muscarinic antagonists (LAMAs), inhaled corticosteroids (ICSs), and respective combinations. At each 3-month interval, discontinuation, switching, addition, and stepping down patterns were analyzed cumulatively for the first 12 months and over the 24-month of follow-up. RESULTS: A total of 3199 patients with at least one prescription of a maintenance therapy at baseline and during 4th-6th month interval were included in the analysis. At diagnosis (0-3 months), the most frequently prescribed maintenance therapy was LABA+ICS (43%), followed by LAMA (24%) and LABA+LAMA+ICS (23%). Nearly half the patients (LABA-50%, LAMA-43%) starting on a monobronchodilator had additions to their treatment in 24 months. Compared to other medications, patients starting on a LAMA were most likely to escalate to triple therapy in 24 months. Nearly one-fourth of the patients prescribed triple therapy at baseline stepped down to LABA+ICS (25%) or LAMA (31%) within 24 months. CONCLUSION: Disease progression is evident over the 24 months after COPD diagnosis, as more patients were prescribed additional maintenance therapy in the 24-month period compared to baseline. The changes in therapy suggest that it is difficult to achieve a consistently improved COPD disease state. |
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| ジャーナル名 | PloS one |
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| 投稿日 | 2014/9/3 |
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| 投稿者 | Wurst, Keele E; Punekar, Yogesh Suresh; Shukla, Amit |
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| 組織名 | Worldwide Epidemiology, GlaxoSmithKline R&D, Research Triangle Park, North;Carolina, United States of America.;Global Health Outcomes, GlaxoSmithKline R&D, Uxbridge, Middlesex, United Kingdom.;Worldwide Epidemiology, GlaxoSmithKline R&D, Upper Providence, Pennsylvania,;United States of America. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/25180802/ |
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