Zietkowski Ziemowit, Lukaszyk Mateusz, Skiepko Roman, Budny Wojciech, Skiepko Urszula, Jóźwik Adam, Bodzenta-Lukaszyk Anna
Department of Allergology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.
Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland.
Postepy Dermatol Alergol. 2019 Apr;36(2):217-222. doi: 10.5114/ada.2019.84596. Epub 2019 May 14.
Progressing deterioration of the lung function, dyspnoea, cough, wheezing and chest tightness are the main features of asthma exacerbations. The first step in the prevention of severe asthma exacerbations is to intensify the anti-inflammatory treatment with high doses of inhaled corticosteroids (ICS).
To assess the efficacy of ciclesonide in patients who have been losing control of asthma despite being treated with medium doses of inhaled corticosteroids and long-acting β-agonists (LABA) as the second controller.
The study was conducted in a group of 74 asthmatic patients who have been losing control of their asthma. Subjects entering the study received the following anti-inflammatory interventions: high doses of ciclesonide (1280 μg) or 640 μg of ciclesonide added to a current dose of ICS or a doubled dose of current ICS.
Treatment options containing ciclesonide have shown statistically and clinically important advantages (improvement of Asthma Control Test score, reduction in rescue medication consumption, reduction in day and night symptoms score, improvement in spirometry parameters, decrease in exhaled nitric oxide, and no necessity of oral corticosteroids treatment) in comparison to patients for whom medium doses of the previously used inhaled corticosteroid were doubled.
Treating with high doses of ciclesonide is characterised by a quick and potent anti-inflammatory effect as well as prompt clinical improvement along with the proper safety profile in patients experiencing asthma exacerbations.
肺功能进行性恶化、呼吸困难、咳嗽、喘息和胸闷是哮喘急性加重的主要特征。预防严重哮喘急性加重的第一步是加大吸入性糖皮质激素（ICS）的抗炎治疗剂量。
评估环索奈德对尽管接受中等剂量吸入性糖皮质激素和长效β受体激动剂（LABA）作为二级控制药物治疗但哮喘仍失控的患者的疗效。
该研究在一组74名哮喘控制不佳的患者中进行。进入研究的受试者接受了以下抗炎干预措施：高剂量环索奈德（1280μg），或在当前ICS剂量中添加640μg环索奈德，或当前ICS剂量加倍。
与中等剂量的先前使用的吸入性糖皮质激素剂量加倍的患者相比，含环索奈德的治疗方案在统计学和临床上均显示出重要优势（哮喘控制测试评分改善、急救药物使用量减少、日夜症状评分降低、肺功能参数改善、呼出一氧化氮减少以及无需口服糖皮质激素治疗）。
高剂量环索奈德治疗具有快速且强效的抗炎作用，能使哮喘急性加重患者临床症状迅速改善，且安全性良好。
