Barry Peter J, Flume Patrick A
a Manchester Adult Cystic Fibrosis Centre , University Hospital of South Manchester , Manchester , United Kingdom of Great Britain and Northern Ireland.
b Institute of Inflammation and Repair , University of Manchester , Manchester , United Kingdom of Great Britain and Northern Ireland.
Expert Rev Respir Med. 2017 Jan;11(1):13-20. doi: 10.1080/17476348.2017.1246358. Epub 2016 Oct 27.
Cystic fibrosis airways disease is characterized by chronic inflammation and infection resulting in bronchiectasis. Published guidelines recommend medications for use by CF patients to maintain lung health. There are conflicting recommendations regarding inhaled bronchodilators. This is primarily because of the interpretation of the available evidence, which suffers from studies using small numbers of subjects, varying doses and durations of treatment, and modest effects on clinically relevant endpoints. Areas covered: Herein we review the available evidence demonstrating the challenge in determining whether bronchodilators have benefit for patients. We examine the potential indications and the current guidance from clinical studies. We highlight the outstanding questions examining bronchodilator use in CF. Expert commentary: The use of bronchodilators in CF remains commonplace despite the lack of solid evidence. Further studies should define key endpoints to determine a role for bronchodilators in light of a substantial treatment burden endured by people with CF.
囊性纤维化气道疾病的特征是慢性炎症和感染，进而导致支气管扩张。已发布的指南推荐囊性纤维化（CF）患者使用药物来维持肺部健康。关于吸入性支气管扩张剂的使用存在相互矛盾的建议。这主要是由于对现有证据的解读存在问题，现有研究存在样本量小、治疗剂量和疗程各异以及对临床相关终点影响不大等情况。涵盖领域：在此，我们回顾现有证据，以证明在确定支气管扩张剂对患者是否有益方面存在的挑战。我们研究了潜在适应症以及临床研究的当前指导意见。我们强调了在囊性纤维化中使用支气管扩张剂方面尚未解决的问题。专家评论：尽管缺乏确凿证据，但支气管扩张剂在囊性纤维化中的使用仍然很普遍。鉴于囊性纤维化患者承受着巨大的治疗负担，进一步的研究应确定关键终点，以明确支气管扩张剂的作用。
