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哮喘药物在妊娠和哺乳期的安全性:临床管理和研究重点。

The safety of asthma medications during pregnancy and lactation: Clinical management and research priorities.

机构信息

Department of Pediatrics, University of California, San Diego, La Jolla, Calif.

University of Illinois at Chicago, Chicago, Ill.

出版信息

J Allergy Clin Immunol. 2021 Jun;147(6):2009-2020. doi: 10.1016/j.jaci.2021.02.037. Epub 2021 Mar 10.

Abstract

Asthma is one of the most common underlying diseases in women of reproductive age that can lead to potentially serious medical problems during pregnancy and lactation. A group of key stakeholders across multiple relevant disciplines was invited to take part in an effort to prioritize, strategize, and mobilize action steps to fill important gaps in knowledge regarding asthma medication safety in pregnancy and lactation. The stakeholders identified substantial gaps in the literature on the safety of asthma medications used during pregnancy and lactation and prioritized strategies to fill those gaps. Short-term action steps included linking data from existing complementary study designs (US and international claims data, single drug pregnancy registries, case-control studies, and coordinated systematic data systems). Long-term action steps included creating an asthma disease registry, incorporating the disease registry into electronic health record systems, and coordinating care across disciplines. The stakeholders also prioritized establishing new infrastructures/collaborations to perform research in pregnant and lactating women and to include patient perspectives throughout the process. To address the evidence gaps, and aid in populating product labels with data that inform clinical decision making, the consortium developed a plan to systematically obtain necessary data in the most efficient and timely manner.

摘要

哮喘是育龄妇女中最常见的基础疾病之一,可导致妊娠和哺乳期出现潜在严重的医疗问题。一组来自多个相关学科的利益攸关方受邀参与,以确定优先事项、制定战略并动员行动步骤,以填补有关妊娠和哺乳期哮喘药物安全性的知识空白。利益攸关方确定了关于妊娠和哺乳期使用的哮喘药物安全性的文献中的重大空白,并确定了填补这些空白的策略。短期行动步骤包括链接现有补充研究设计(美国和国际索赔数据、单一药物妊娠登记、病例对照研究和协调系统数据系统)的数据。长期行动步骤包括创建哮喘疾病登记处,将疾病登记处纳入电子健康记录系统,并协调跨学科的护理。利益攸关方还优先建立新的基础设施/合作关系,以便在孕妇和哺乳期妇女中进行研究,并在整个过程中纳入患者的观点。为了解决证据空白问题,并在产品标签中填充有助于临床决策的数据,该联盟制定了一项计划,以最有效和及时的方式系统地获取必要的数据。

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