combination_therapy_in_asthma__COPD解读.ppt

* * ODonnell DE, Sciurba F, Celli B, et al. Effect of fluticasone propionate/salmeterol on lung hyperinflation and exercise endurance in COPD. Chest 2006; 130: 647-56. * * SFC statistically significantly better than placebo at 6-months (p=0.001) Adjusted mean change at 3 years SFC= -1.2, FP = -0.2, Sal = 1, Plac = 2.1 Therefore Steroid containing groups prevented expected decline over 3 years I want to build this slide starting with placebo, then salmeterol, then FP then SFC Also put in line for zero Move legend to upper right arranged vertically building with the plots Haven’t yet formed a view about the nos. at the bottom of the slide * Includes several different types of preferred terms for pneumonia 研究观察到SFC组肺炎患者的死亡率无升高；FP组患者未观察 * * There were no difference in total AE between Symbicort or Budesonide versus placebo (i.e. no budesonede). i.e. no enhanced risk for pneumonia vs controls = no ICS, given formoterol or placebo) In a country where linking of patient databases is more evident, the Swedes have just published the first of a series of publications looking at more than 20,000 COPD patients in their country over an 11-year period. This study is called Providing Answers To Healthcare by Observational Studies (PATHOS). Please note that PATHOS is Level III-2 evidence, and provides interesting new data on differences between ICS/LABA (study funded by AstraZeneca). This is a unique study that cannot be done in Australia as our data are unlinked. This observational retrospective study looked at 21,361 patients who had a recording of COPD diagnosis and followed over an 11-year period. Of these patients, 9893 had a record of ICS/LABA (DPI only no MDI in Sweden). 7153 were treated with BUD/FOR and 2738 with FLU/SAL. These FLU/SAL patients were matched to the BUD/FOR using a pairwise propensity score matching covering 31 variables (e.g. age, gender, time from COPD diagnosis,, medication, hospitalisation for exacerbations and co-morbidities). Only 4 FLU/SA