Boulet Louis-Philippe
Institut de cardiologie et de pneumologie de l'Université Laval, Hôpital Laval, Quebec City, QC, Canada.
Curr Opin Pulm Med. 2004 Jan;10(1):15-21. doi: 10.1097/00063198-200401000-00004.
Inhaled corticosteroids (ICS) are the mainstay of asthma therapy. Although compliance to this type of medication is often suboptimal and once-daily dosing can help to improve adherence to the treatment, the clinical implications of such a mode of administration should be determined.
This review summarizes the recent studies on comparative efficacy of once-versus twice-daily administration of ICS, in light of previous reports.
Although twice-daily administration of ICS is often better to optimize asthma parameters, in many patients, asthma can be sufficiently controlled by a once-daily regimen of most ICS. An increased frequency of dosing seems preferable if asthma becomes uncontrolled or is severe, although this requires further study. A therapeutic trial should, however, be done to ensure that asthma control is adequate. Comparative long-term effects of such a strategy on inflammatory and remodeling parameters remain to be determined, as does the proportion of patients who can adequately control their asthma with once-daily administration of the various ICS available.
吸入性糖皮质激素(ICS)是哮喘治疗的主要药物。尽管对这类药物的依从性往往不理想,每日一次给药有助于提高治疗依从性,但这种给药方式的临床意义仍需确定。
本综述根据既往报告,总结了近期关于ICS每日一次与每日两次给药比较疗效的研究。
尽管每日两次给予ICS通常更有利于优化哮喘参数,但在许多患者中,大多数ICS每日一次给药方案可充分控制哮喘。如果哮喘控制不佳或病情严重,增加给药频率似乎更可取,不过这还需要进一步研究。然而,应进行治疗试验以确保哮喘得到充分控制。这种策略对炎症和重塑参数的长期比较影响仍有待确定,能通过每日一次给予现有各种ICS充分控制哮喘的患者比例也有待确定。