从PATHOS看慢阻肺管理.ppt

* Compared with FLU/SAL Diskus, BUD/FOR Turbuhalor was associated with reduced risk : of all kind of exacerbations by 26 % (26,6%), here presented as event/100 patient/year; 80/100 vs 109/100: NNT = 3.4 Budesonide/formoterol had 26.0% fewer oral steroid courses and 29.0% fewer antibiotic courses reduced risk of hospitalizations due to COPD by 29% and 21.0% lower risk for ER visits in the budesonide/formoterol treatment group All highly significant The mean collected budesonide dose was 568μg/day for matched patients who were prescribed budesonide/formoterol and the mean fluticasone dose was 783 μg/day for patients who were prescribed fluticasone/salmeterol, corresponding to 89% vs 78% of recommended labeled dose in COPD; budesonide 640 μg/day and fluticasone 1000 μg/d (delivered dose). * These figure shows cumulative event rates (pneumonias)/100 patients versus time. Compared to budesonide/formoterol treatment, there was a 73% higher rate of pneumonia in the fluticasone/salmeterol treatment group We can see a uniform pattern versus time for “all pneumonias” and for “hospitalised pneumonias” . The differences observed for the budesonide/formoterol vs the fluticasone/salmeterol groups with regard to diagnosis of pneumonia was independent of where the pneumonia diagnosis was recorded, in primary care or at hospital (67% of all pneumonias were pneumonias diagnosed at hospitals where X-ray is used). Compared to budesonide/formoterol treatment, pneumonia-related hospitalisations were 74% higher in the fluticasone/salmeterol treatment group. NNT to avoid one pneumonia event per year of 22 The figure shows that 100 patients will have more than 100 pneumonia during 9 years in SAL/FLU treated patients. The figure shows not that some patients will be without pneumonia. TORCH: Using an analysis of rates, it is estimated there would be one extra case of pneumonia for every 31 patients receiving treatment with SFC over 1 yr. * The results are presented as