PT -期刊文章AU -哈尔平,大卫M.G. AU - Dransfield,马克·t . AU -汉美兰k . AU -琼斯,c·伊莱恩AU -基尔布赖德,莎莉AU -兰格,彼得盟利普森,David a . AU -洛马斯,David a . AU -马丁内斯,费尔南多·j . AU -帕斯科,史蒂夫AU -辛格,戴夫AU -明智,罗伯特盟。克里内,杰拉德j . TI -恶化历史的影响在影响审判结果援助- 10.1183/13993003.01921 -2019 DP - 2020年5月01 TA -欧洲呼吸杂志》第六PG - 1901921 - 55 IP - 5 4099 - //www.qdcxjkg.com/content/55/5/1901921.short 4100 - //www.qdcxjkg.com/content/55/5/1901921.full所以欧元和J2020可能01;55 AB - IMPACT是一项为期52周的随机双盲试验，评估了糠酸氟替卡松/umeclidinium/vilanterol (FF/UMEC/VI)三联疗法与FF/VI或UMEC/VI疗法对症状性COPD和有加重史的患者的疗效和安全性。亚组分析评估FF/UMEC/VI vs . FF/VI或UMEC/VI和UMEC/VI vs . FF/VI的疗效是否因既往加重史、加重史和血液嗜酸性粒细胞计数的联合作用而变化。定义了三个亚组:单个中度(1例中度/无重度;N =3056(30%))、频繁中度(≥2例中度/无重度;N =4628(45%))和重度(≥1例重度/任何中度;n = 2671(26%))。终点包括每年治疗中/严重恶化率(预先指定)、肺功能和健康状况(均为治疗后)。FF/UMEC/VI组与FF/VI组(单次中20%(10-29)，频繁中11%(2-19)，严重中17%(7-26))和UMEC/VI组(单次中18%(5-29)，频繁中29%(21-37)，严重26%(14-35))相比，中/重度加重率(降低% (95% CI))有所降低。与频繁中度亚组的UMEC/VI相比，FF/VI组的中度/重度加重率有所降低; a numerical reduction was observed in the severe subgroup (single moderate 2% (−12–18), frequent moderate 21% (11–29), severe 11% (−3–22)). Moderate/severe exacerbation rates were lower in the FF/VI group compared with UMEC/VI in patients with higher eosinophil counts. FF/UMEC/VI improved lung function and health status versus both dual therapies irrespective of exacerbation subgroup. UMEC/VI improved lung function versus FF/VI in all subgroups.Triple therapy was more effective than dual regardless of exacerbation history, consistent with results in the intent-to-treat population. Comparisons between dual therapies were influenced by prior exacerbation history and eosinophil counts.FF/UMEC/VI shows benefits vs FF/VI and UMEC/VI across multiple endpoints irrespective of exacerbation history. Exacerbation history and eosinophils influenced the comparison between UMEC/VI and FF/VI, and eosinophils that between FF/UMEC/VI and UMEC/VI. http://bit.ly/2SHu2ey