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花粉季节中过敏性鼻炎治疗中按需用药与规律用药的比较:一项MASK-air研究。

As-Needed Versus Regular Medication Use in the Treatment of Allergic Rhinitis in the Pollen Season: A MASK-air Study.

临床研究鼻科IF 11.7Q1

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中文摘要

背景: 过敏性鼻炎患者常使用按需药物而非规律治疗。利用MASK-air移动健康应用程序的数据,我们比较了按需用药周与规律用药周在治疗满意度和症状控制方面的差异。
方法: 我们评估了MASK-air应用程序的数据。我们比较了花粉季节中患者报告一周内所有天数使用同一种药物(“规律治疗”)的周与患者报告每周最多4天使用同一种单一药物(且无其他治疗)(“按需治疗”)的周。我们构建了混合效应线性回归模型,评估规律治疗与按需治疗在症状控制和治疗满意度视觉模拟量表上的差异。我们进行了敏感性分析:(i)考虑按需治疗的另一种定义(每周用药≤2天),以及(ii)评估治疗日之前为非治疗日的情况。
结果: 我们评估了2690周(18,830天,1042名MASK-air用户)。对于鼻内皮质类固醇(INCS)和鼻内抗组胺药(INAH)+ INCS的固定复方制剂,按需治疗与规律治疗在治疗满意度方面无显著差异。对于口服抗组胺药(OAH)和INCS + OAH,结果倾向于支持按需治疗。对于症状控制,我们观察到两种方法之间要么无显著差异,要么显著差异支持按需用药。敏感性分析中发现了类似的结果。
结论: 一些患者规律用药,另一些患者按需用药。本研究表明,两种方法均可令患者满意并实现良好的疾病控制。

英文摘要

BACKGROUND: Patients with allergic rhinitis often use as-needed medication instead of regular treatment. Using data from the MASK-air mHealth app, we compared weeks with use of as-needed versus regular medication on treatment satisfaction and symptom control.
METHODS: We assessed data from the MASK-air app. We compared weeks in the pollen season in which patients reported the use of one same medication during all the days in the week ("regular treatment") versus those in which patients reported the use of the same single medication (and no other treatments) in at most 4 days per week ("as-needed treatment"). We built mixed-effects linear regression models, evaluating the differences between regular and as-needed treatments on visual analogue scales for symptom control and treatment satisfaction. We performed sensitivity analyses (i) considering a different definition of as-needed treatment (use of medication ≤ 2 days per week), and (ii) evaluating treatment days preceded by non-treatment days.
RESULTS: We assessed 2690 weeks (18,830 days, 1042 MASK-air users). For intranasal corticosteroids (INCS) and fixed combinations of intranasal antihistamines (INAH) + INCS, there were no significant differences between as-needed versus regular treatments for treatment satisfaction. For oral antihistamines (OAH) and INCS + OAH, results tended to favour as-needed approaches. For symptom control, we observed either no significant differences between the two approaches or significant differences favouring as-needed medication use. Similar results were found in the sensitivity analyses.
CONCLUSION: Some patients use medication regularly and others use it on-demand. This study shows that both approaches can satisfy patients and result in good disease control.