@article {Wing2001586, author = {Wing, Kevin和Williamson, Elizabeth和Carpenter, James R.和Wise, Lesley和Schneeweiss, Sebastian和Smeeth, Liam和Quint, Jennifer K.和Douglas, Ian},标题= {COPD药物的真实世界影响:一项队列研究,验证了来自随机对照试验的结果},volume = {57}, number = {3}, location-id = {2001586}, year = {2021}, doi = {10.1183/13993003.01586-2020}, publisher ={欧洲呼吸学会},188bet官网地址现实世界的数据提供了在被排除在试验之外的群体中产生药物治疗效果的证据的可能性,但是缺乏严格的、有效的方法来这样做。我们调查了应用于现实世界数据的非介入方法是否可以重现具有里程碑意义的TORCH COPD试验的结果。我们在英国临床实践研究数据链(CPRD)中开展了一项COPD药物治疗效果的历史队列研究(2000年)。采用TORCH纳入/排除标准,与TORCH参与者1:1匹配,从CPRD中选择两个对照组,如下。对照组1:COPD患者未使用丙酸氟替卡松(FP)-沙美特罗(SAL);对照组2:COPD患者仅服用SAL。然后从CPRD中选择FP-SAL暴露组,倾向评分匹配于每个对照组。研究结果包括COPD加重、任何原因死亡和肺炎。2652 FP-SAL exposed people were propensity score matched to 2652 FP-SAL unexposed people while 991 FP-SAL exposed people were propensity score matched to 991 SAL exposed people. Exacerbation rate ratio was comparable to TORCH for FP-SAL versus SAL (0.85, 95\% CI 0.74{\textendash}0.97 versus 0.88, 0.81{\textendash}0.95) but not for FP-SAL versus no FP-SAL (1.30, 1.19{\textendash}1.42 versus 0.75, 0.69{\textendash}0.81). In addition, active comparator results were consistent with TORCH for mortality (hazard ratio 0.93, 0.65{\textendash}1.32 versus 0.93, 0.77{\textendash}1.13) and pneumonia (risk ratio 1.39, 1.04{\textendash}1.87 versus 1.47, 1.25{\textendash}1.73).We obtained very similar results to the TORCH trial for active comparator analyses, but were unable to reproduce placebo-controlled results. Application of these validated methods for active comparator analyses to groups excluded from randomised controlled trials provides a practical way for contributing to the evidence base and supporting COPD treatment decisions.In COPD patients selected from real-world data based on similarity to participants of the TORCH RCT, non-interventional methods generated comparable results to the TORCH analysis of LABA-ICS versus LABA in relation to exacerbations, mortality and pneumonia https://bit.ly/33ky5D0}, issn = {0903-1936}, URL = {//www.qdcxjkg.com/content/57/3/2001586}, eprint = {//www.qdcxjkg.com/content/57/3/2001586.full.pdf}, journal = {European Respiratory Journal} }