Tổng quan hệ thống về hiệu lực, hiệu quả, an toàn và chi phí - hiệu quả của Budesonide/Glycopyrrolate/Formoterol fumarate trong điều trị bệnh phổi tắc nghẽn mạn tính

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Tác giả: Châu Minh Thư Lê, Phạm Mai Chi Nguyễn, Quốc Hòa Nguyễn, Thị Hải Yến Nguyễn, Thị Quỳnh Nga Nguyễn, Thị Hồng Nguyên Trần

Ngôn ngữ: vie

Ký hiệu phân loại: 616.23 *Diseases of trachea and bronchi

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2023

Mô tả vật lý: 286-295

Bộ sưu tập: Metadata

ID: 502355

Thêm vào giỏ

Phối hợp ba thuốc budesonide/glycopyrrolate/formoterol fumarate (BGF) có tiềm năng giúp tăng tuân thủ và hiệu quả điều trị cho người bệnh phổi tắc nghẹn mạn tính (COPD). Mục tiêu: Nghiên cứu tổng quan hệ thống về hiệu lực, hiệu quả, an toàn, chi phí - hiệu quả của budesonide/ glycopyrrolate/formoterol fumarate trong điều trị COPD để cung cấp các bằng chứng cho các cơ quan quản lý và các nhà hoạch định trong việc lựa chọn thuốc. Phương pháp nghiên cứu: Tổng quan hệ thống thực hiện theo hướng dẫn thực hiện tổng quan hệ thống của PRISMA trên Pubmed và Embase. Kết quả nghiên cứu: Trong 16 nghiên cứu thỏa mãn tiêu chí lựa chọn được đưa vào tổng quan, 12/16 có thiết kế là RCT (hai RCT lớn là ETHOS và KRONOS). Kết quả cho thấy BGF trong đó liều budesonide 160-μg và 320-μg đều cải thiện chức năng phổi, các triệu chứng và đợt cấp COPD, bất kể tiền sử đợt cấp COPD. Hồ sơ an toàn của BGF nhìn chung tương đương với các nhóm so sánh. Phối hợp BGF cũng cho thấy đạt chi phí hiệu quả so với phối hợp hai thuốc LAMA/LABA và ICS/LABA. Kết luận: Sử dụng phối hợp ba BGF có hiệu quả, dung nạp tốt, đạt chi phí-hiệu quả và có thể là phương pháp điều trị thích hợp hơn so với liệu pháp kép tương ứng và có tiềm năng so với phối hợp ba thuốc dành cho người bệnh COPD từ trung bình đến rất nặng.The triple inhaled therapy budesonide/glycopyrrolate/formoterol fumarate (BGF) has the potential to increase adherence and efficacy in patients with chronic obstructive pulmonary disease (COPD). Objective: To systematically review the efficacy, effectiveness, safety, and cost-effectiveness of BGF in the treatment of COPD. Methods: The systematic review was conducted according to the guidance of PRISMA guidelines using 2 databases (Pubmed and Embase). Results: Of 16 included studies, 12/16 were RCTs (two large RCTs were ETHOS and KRONOS). BGF wherein budesonide dose of 160-μg and 320-μg improved lung function, symptoms and COPD exacerbation rate, regardless of history of COPD exacerbations. The safety profile of BGF was generally comparable to that of the comparison groups. BGF was cost-effective compared to other dual therapies such as LAMA/LABA or ICS/LABA. Conclusions: BGF was efficacious, well tolerated, cost-effective and could be a more appropriate treatment than the corresponding dual therapies and have potential compared to triple therapies for symptomatic patients with moderate to very severe COPD.

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