Department of Respiratory Medicine and Thoracic Surgery, Institute for Lung Health, Glenfield Hospital, Leicester, UK.
J Asthma Allergy. 2011;4:1-12. doi: 10.2147/JAA.S8671. Epub 2010 Dec 30.
It is increasingly recognized that large proportions of patients with asthma remain poorly controlled with daily symptoms, limitation in activities, or severe exacerbations despite traditional treatment with inhaled corticosteroids and other agents. This suggests that there is considerable scope for the refinement of traditional guidelines on the use of inhaled therapies in asthma and also a need for the development of novel therapeutic agents, particularly for the treatment of severe asthma. This review aims to discuss a range of emerging treatment approaches in asthma. Firstly, we will set the scene by highlighting the importance of achieving good asthma control in a patient-focused manner and discussing recent work that has furthered our understanding of asthma phenotypes and paved the way for patient-specific treatments. Secondly, we will review new strategies to better use the existing therapies such as inhaled corticosteroids and long-acting β(2)-agonists that remain the mainstay of treatment for most patients. Finally, we will review the novel therapies that are becoming available, both pharmacological and interventional, and discuss their likely place in the management of this complex disease.
越来越多的人认识到,尽管采用了吸入皮质激素和其他药物的传统治疗方法,但仍有很大比例的哮喘患者存在日常症状、活动受限或严重恶化控制不佳的情况。这表明,在哮喘吸入治疗的传统指南的精细化方面有很大的空间,同时也需要开发新的治疗药物,特别是用于治疗严重哮喘。本文旨在讨论哮喘治疗的一系列新方法。首先,我们将从强调以患者为中心实现良好哮喘控制的重要性入手,并讨论最近的工作,这些工作进一步加深了我们对哮喘表型的理解,并为患者特异性治疗铺平了道路。其次,我们将审查更好地利用现有治疗方法的新策略,如吸入皮质激素和长效β2-激动剂,这些仍然是大多数患者治疗的主要方法。最后,我们将审查新的治疗方法,包括药理学和介入治疗,并讨论它们在管理这种复杂疾病中的可能位置。