Meghdadpour Susanne, Lugogo Njira L
Division of Pulmonary, Department of Pediatrics, Allergy and Sleep Medicine, Duke University, Durham, North Carolina.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan, Ann Arbor, Michigan.
Respir Care. 2018 Jun;63(6):759-772. doi: 10.4187/respcare.05957.
Guideline-based management of asthma was developed as a means of standardizing asthma therapies and of improving outcomes. The National Asthma Education and Prevention Program and the Global Initiative for Asthma guidelines provide recommendations to care providers about the routine management of asthma. There has been rapid development of new therapies for asthma, specifically with the advent of new drug delivery devices and biologic therapies for severe asthma. We are increasingly recognizing that asthma is a heterogenous disease with a diverse underlying pathophysiology, and therefore, it is imperative for care providers to begin to understand asthma phenotypes and endotypes, and the implications of these classifications on management, especially of severe refractory asthma. This article serves as a review of guideline-based therapy for asthma and includes updates on alternative therapies, new approaches that use previously recognized therapies, and special populations with asthma.
基于指南的哮喘管理方法旨在规范哮喘治疗并改善治疗效果。国家哮喘教育与预防计划以及全球哮喘防治创议指南为医护人员提供了哮喘常规管理的建议。随着新的药物递送装置和重症哮喘生物疗法的出现,哮喘新疗法迅速发展。我们越来越认识到哮喘是一种具有多种潜在病理生理学的异质性疾病,因此,医护人员必须开始了解哮喘的表型和内型,以及这些分类对管理的影响,尤其是对重症难治性哮喘的管理。本文对基于指南的哮喘治疗进行综述,包括替代疗法的更新、使用先前认可疗法的新方法以及哮喘特殊人群的情况。