索利氨酚用于残余嗜睡及其对持续气道正压通气依从性的影响：一项法国数据库分析

文献信息

中文摘要

背景： 索利氨酚可能改善阻塞性睡眠呼吸暂停综合征（OSA），同时可能影响CPAP依从性。
研究问题： 探讨因残余嗜睡而起始索利氨酚治疗对成人OSA患者CPAP依从性和终止率的影响。
研究设计： 分析了法国国家健康数据系统（SNDS）数据库的数据，该数据库包含法国超过99%个体的医疗支出报销数据。纳入所有在2021年9月1日至2023年6月30日期间至少接受过一次索利氨酚给药，且在索利氨酚给药索引日期前12个月内至少获得过一次CPAP报销的OSA患者。根据该治疗在4周周期内的报销水平计算CPAP依从性评分：评分=3（平均每晚超过4小时），评分=2（平均每晚2至4小时），评分=1（平均每晚少于2小时），患者不再使用CPAP：评分=0。对于每位患者，我们计算了索利氨酚起始索引日期前后6个4周序列的平均评分。从SNDS中接受CPAP治疗的OSA患者中，通过倾向评分匹配对照组与接受CPAP和索利氨酚治疗的受试者。
结果： 纳入930名起始索利氨酚治疗的OSA患者，并与8,920名对照匹配。病例组和对照组的特征相似（年龄=56.4岁和57.1岁，男性占64.5%和64.6%，合并症负担相同）。在索利氨酚治疗开始前后6个月，索利氨酚组的平均CPAP依从性评分略高于对照组，但差异显著（治疗前：2.8 vs. 2.6，p < 0.0001；治疗后：2.8 vs. 2.5，p < 0.0001）。
结论： 我们未发现索利氨酚起始治疗与CPAP依从性降低相关的证据。

英文摘要

BACKGROUND: Solriamfetol may improve obstructive sleep apnoea syndrome (OSA) while potentially influencing CPAP adherence.
RESEARCH QUESTION: To investigate the impact of solriamfetol initiation for residual sleepiness on CPAP adherence and termination rates in adults with OSA.
STUDY DESIGN: Data from the French Système National des Données de Santé (SNDS) database, which contains data on health spending reimbursements for > 99% of all individuals living in France, were analyzed. All OSA patients who received at least one administration of solriamfetol for between 09/01/2021 and 06/30/2023 and who received at least one CPAP reimbursement in the 12 months before the index date of solriamfetol administration were included. A CPAP adherence score was calculated based on the reimbursement levels for this treatment over 4-week periods: score = 3 (more than 4 hours per night on average), score = 2 (between 2 and 4 hours per night on average), score = 1 (less than 2 hours per night on average), patient no longer using CPAP: score=0. For each patient, we calculated the average score over 6 sequences of 4 weeks preceding and following the index date of solriamfetol initiation. A control group from the SNDS CPAP-treated OSA was matched by propensity score to subjects treated with CPAP and solriamfetol.
RESULTS: 930 OSA patients initiated on solriamfetol were included and matched to 8,920 controls. The characteristics of the cases and controls were similar (age = 56.4 and 57.1 years, 64.5% and 64.6% male, and same burden of comorbidities). During the 6 months before and after the start of solriamfetol treatment, the mean CPAP adherence score was slightly but significantly higher in the solriamfetol group than in the control group (before: 2.8 vs. 2.6, p < 0.0001, after: 2.8 vs. 2.5, p < 0.0001).
CONCLUSION: We found no evidence that solriamfetol initiation was associated with reduced CPAP adherence.