Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Curr Opin Pulm Med. 2019 Jan;25(1):27-33. doi: 10.1097/MCP.0000000000000539.
The goal of this review is to discuss strategies to prevent asthma exacerbations in children, focusing on recent advances in knowledge and understanding.
Asthma exacerbations are common, and their prevention is an important goal to avoid detrimental impacts such as loss of disease control and lung function and significant healthcare costs. A number of strategies have been studied as tools for prevention of asthma exacerbations. Daily inhaled corticosteroids (ICSs) are effective for many children with asthma. However, alternative strategies such as intermittent ICS therapy, antileukotrienes, and biologics have been studied as means to lessen corticosteroid exposure. Further, recent studies have examined add-on strategies for children not controlled with ICS alone. Finally, personalizing therapy with targeted approaches has provided significant benefit to those with moderate-severe disease.
Recent research highlights many potentially effective treatment strategies to prevent asthma exacerbations in children. We have reviewed and summarized the data on treatment approaches to help provide a better understanding of the methods that can be utilized. An individualized approach with careful monitoring is essential to identify the most effective strategies to prevent asthma exacerbations in each child.
本篇综述旨在讨论预防儿童哮喘恶化的策略,重点介绍相关知识和理解方面的最新进展。
哮喘恶化很常见,预防哮喘恶化是避免疾病控制和肺功能丧失以及显著增加医疗成本等不良影响的重要目标。已经研究了许多策略作为预防哮喘恶化的工具。每日吸入皮质类固醇(ICS)对许多哮喘儿童有效。然而,作为减少皮质类固醇暴露的手段,间歇性 ICS 治疗、白三烯拮抗剂和生物制剂等替代策略也进行了研究。此外,最近的研究还研究了针对单独使用 ICS 控制不佳的儿童的附加策略。最后,针对中重度疾病的靶向治疗方法为患者提供了显著的益处。
最近的研究强调了许多预防儿童哮喘恶化的潜在有效治疗策略。我们回顾并总结了这些治疗方法的数据,以帮助更好地理解可以利用的方法。个体化治疗和密切监测对于确定预防每个儿童哮喘恶化的最有效策略至关重要。