Plaza Vicente, Alobid Isam, Alvarez Cesáreo, Blanco Marina, Ferreira Jorge, García Gabriel, Gómez-Outes Antonio, Gómez Fernando, Hidalgo Antonio, Korta Javier, Molina Jesús, Pellegrini Francisco Javier, Pérez Montserrat, Plaza Javier, Praena Manuel, Quirce Santiago, Sanz José
Comité Ejecutivo GEMA, Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
Sociedad Española de Otorrinolaringología (SEORL), Hospital Clinic, Universidad de Barcelona, Barcelona, España.
Arch Bronconeumol. 2022 Feb;58(2):150-158. doi: 10.1016/j.arbres.2021.05.010. Epub 2021 May 26.
In this fifth phase of development, the contents of the Spanish Asthma Management Guidelines (GEMA), which include versions 5.0 and 5.1, have undergone a thorough review. The aim here is to set the main changes in context. These could be summarized as follows: DIAGNOSIS: new FE cut-off and severity classification based on treatment needed to maintain control; INTERMITTENT ASTHMA: a more restrictive concept and treatment extended to include a glucocorticoid/adrenergic combination as needed; MILD ASTHMA: glucocorticoid/adrenergic therapy as needed as an alternative in case of low therapeutic adherence to conventional fixed-dose steroids; SEVERE ASTHMA: readjustment of phenotypes, incorporation of triple therapy in a single inhaler, and criteria for selection of a biologic in severe uncontrolled asthma; OTHERS: specific scoring in childhood asthma, incorporation of certain organizational aspects (care circuits, asthma units, telemedicine), new sections on COVID-19 and nasal polyposis.
在这一第五阶段的发展中,西班牙哮喘管理指南(GEMA)的内容,包括5.0版和5.1版,已经接受了全面审查。此处的目的是阐述主要变化的背景情况。这些变化可总结如下:诊断:基于维持控制所需治疗的新的肺功能(FE)临界值和严重程度分类;间歇性哮喘:概念更为严格,治疗范围扩大至包括按需使用糖皮质激素/肾上腺素能药物联合治疗;轻度哮喘:在对传统固定剂量类固醇治疗依从性较低的情况下,按需使用糖皮质激素/肾上腺素能药物治疗作为替代方案;重度哮喘:调整表型,将三联疗法纳入单一吸入器,并为重度未控制哮喘选择生物制剂制定标准;其他:儿童哮喘的特定评分,纳入某些组织方面的内容(护理流程、哮喘专科、远程医疗),关于2019冠状病毒病(COVID-19)和鼻息肉的新章节。