Pauwels R
Department of Respiratory Diseases, University Hospital Ghent, Belgium.
Respir Med. 2001 Aug;95 Suppl B:S30-4. doi: 10.1053/rmed.2001.1144.
Drugs available to treat asthma have improved considerably over the past three decades and understanding of the disease process is continually improving. However, the incidence of asthma is increasing and the cause(s) of this increase are not yet identified. Asthma is often underdiagnosed and undertreated. Poor compliance with medication is also an important consideration in how effective management strategies can be. The aim of current asthma treatment, according to the Global Initiative for Asthma (GINA), is to control the disease. However, two surveys, one in Europe and the other in the U.S.A. indicate that the objectives of treatment guidelines are not being met. Patients were shown to experience high rates of exacerbations and require many doses of reliever medication. There was also a large difference between patient and physician perceptions of treatment--this needs to be countered by improved education for both the general public and healthcare professionals. Formoterol, which is the only beta2-agonist to possess both fast- and long-acting properties, may help to improve patient compliance by allowing a single inhaler to be used for both maintenance and as-needed therapy. However, although formoterol is already widely used as maintenance therapy current treatment guidelines do not include the use of formoterol as first-line reliever medication. Evidence is increasing to support as-needed use and a large, randomized effect veness study in 18,000 patients across the world is ongoing to assess the safety and efficacy of formoterol as needed in a real-life setting. The results from the Real-Life Effectiveness of Oxis Turbuhaler (RELIEF) study should help to establish the position of formoterol as an effective first line reliever medication and ultimately lead to the inclusion of formoterol as needed in treatment guidelines.
在过去三十年中，可用于治疗哮喘的药物有了显著改善，并且对疾病过程的认识也在不断提高。然而，哮喘的发病率正在上升，而这种上升的原因尚未确定。哮喘常常诊断不足且治疗不充分。药物依从性差也是影响管理策略有效性的一个重要因素。根据全球哮喘防治创议（GINA），当前哮喘治疗的目标是控制疾病。然而，欧洲和美国的两项调查表明，治疗指南的目标并未实现。结果显示，患者病情加重的发生率很高，并且需要多次使用缓解药物。患者和医生对治疗的认知之间也存在很大差异——这需要通过加强对公众和医疗保健专业人员的教育来加以应对。福莫特罗是唯一一种兼具速效和长效特性的β2受体激动剂，通过允许使用单一吸入器进行维持治疗和按需治疗，可能有助于提高患者的依从性。然而，尽管福莫特罗已被广泛用作维持治疗，但当前的治疗指南并未将福莫特罗用作一线缓解药物。越来越多的证据支持按需使用，一项针对全球18000名患者的大型随机有效性研究正在进行，以评估福莫特罗在现实生活环境中按需使用的安全性和有效性。奥克斯都保真实生活有效性（RELIEF）研究的结果应有助于确立福莫特罗作为一种有效的一线缓解药物的地位，并最终导致治疗指南中纳入按需使用福莫特罗的内容。
