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[全身性糖皮质激素用于重度哮喘治疗:西班牙多学科共识]

[Use of systemic glucocorticoids for the treatment of severe asthma: Spanish Multidisciplinary Consensus].

作者信息

Domínguez-Ortega Javier, Delgado Romero Julio, Muñoz Gall Xavier, Marco Amparo, Blanco-Aparicio Marina

机构信息

Departamento de Alergia, Hospital La Paz, Instituto de Investigación IDiPAZ, Madrid, España.

Ciber de enfermedades respiratorias CIBERes, Madrid, España.

出版信息

Open Respir Arch. 2022 Sep 6;4(4):100202. doi: 10.1016/j.opresp.2022.100202. eCollection 2022 Oct-Dec.

Abstract

BACKGROUND AND AIM

Since their effectiveness was initially demonstrated, oral corticosteroids (OCS) have been routinely used to treat asthma. We now know that their usage is linked to the development of side effects such osteoporosis and adrenal insufficiency. This is an observational study based on Delphi methodology. The questionnaire was divided into 4 sections: OCS generalities, maintenance treatment, short-term treatment, and adverse events.

MATERIALS AND METHODS

Two rounds of a 68-item questionnaire were completed by a panel of 48 allergists and pneumologists.

RESULTS

Definitions were agreed upon, as was the proper use of OCS in the treatment of severe asthma. The experts agreed that the use of OCS should be minimized as much as possible and that in the event of maintenance treatments, a slow and progressive tapering strategy should be used. They also emphasized the importance of standardizing the technique for measuring the amount of SCG delivered in both cases.

CONCLUSIONS

This consensus document attempts to bring together scientifically supported suggestions from specialists in the management of asthma to reduce the use of OCS in Spain.

摘要

背景与目的

自从口服糖皮质激素(OCS)的有效性最初得到证实以来,它们一直被常规用于治疗哮喘。我们现在知道,其使用与骨质疏松症和肾上腺功能不全等副作用的发生有关。这是一项基于德尔菲法的观察性研究。问卷分为4个部分:OCS概述、维持治疗、短期治疗和不良事件。

材料与方法

由48名过敏症专科医生和肺病专家组成的小组完成了两轮包含68个项目的问卷。

结果

就定义以及OCS在重度哮喘治疗中的正确使用达成了一致意见。专家们一致认为,应尽可能减少OCS的使用,并且在维持治疗的情况下,应采用缓慢且逐步减量的策略。他们还强调了在这两种情况下标准化测量吸入糖皮质激素(SCG)输送量技术的重要性。

结论

本共识文件试图汇集哮喘管理专家的科学支持建议,以减少西班牙OCS的使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41cd/10369533/3de179335cba/fx1.jpg

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