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哮喘维持和缓解治疗:这应该是标准的治疗方法吗?

Asthma maintenance and reliever therapy: Should this be the standard of care?

机构信息

Firestone Institute for Respiratory Health, St. Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Firestone Institute for Respiratory Health, St. Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

出版信息

Ann Allergy Asthma Immunol. 2020 Aug;125(2):150-155. doi: 10.1016/j.anai.2020.04.009. Epub 2020 Apr 24.

Abstract

OBJECTIVE

The goal of asthma management is to achieve optimal asthma control, defined by the absence of daytime symptoms, nighttime waking, reliever use, functional limitation, and lung function stability, and to also reduce the future risks of asthma exacerbations, deterioration in lung function, and the medication's adverse effects. The most widely used maintenance therapy is inhaled corticosteroids (ICSs). This review considered the evidence in which the combination of the ICS budesonide and the rapid-onset long-acting β-agonist (LABA) formoterol can be used as a standard of care for maintenance and reliever therapy in moderate to severe asthma.

DATA SOURCES

The archival literature of peer-reviewed studies on the efficacy and safety of budesonide-formoterol as maintenance and reliever therapy in moderate to severe asthma.

RESULTS

The ICS-LABA combination containing budesonide-formoterol reduces future risk of severe asthma exacerbations and provides similar levels of day-to-day asthma control when compared with using high-dose ICS alone, or combination ICS-LABA therapy and short-acting β-agonist as a reliever.

CONCLUSION

Budesonide-formoterol as a single combination maintenance and reliever inhaler is effective in reducing asthma exacerbation risk, requires a lower maintenance dose of ICS, and results in a simplified approach to asthma management.

摘要

目的

哮喘管理的目标是实现最佳的哮喘控制,定义为无日间症状、夜间觉醒、缓解剂使用、功能受限和肺功能稳定,同时降低哮喘恶化、肺功能恶化和药物不良反应的未来风险。最广泛使用的维持治疗是吸入皮质类固醇(ICSs)。本综述考虑了ICS 布地奈德和快速起效长效β-激动剂(LABA)福莫特罗联合使用作为中重度哮喘维持和缓解治疗的标准护理的证据。

资料来源

关于布地奈德-福莫特罗作为中重度哮喘维持和缓解治疗的疗效和安全性的同行评审研究的档案文献。

结果

ICS-LABA 联合制剂布地奈德-福莫特罗降低了未来重度哮喘恶化的风险,并提供了与单独使用高剂量 ICS 或联合 ICS-LABA 治疗和短效β-激动剂作为缓解剂相似的日常哮喘控制水平。

结论

布地奈德-福莫特罗作为单一联合维持和缓解吸入器在降低哮喘恶化风险方面有效,需要较低的 ICS 维持剂量,并简化了哮喘管理方法。

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