Pavón-Romero Gandhi Fernando, Falfán-Valencia Ramcés, Gutiérrez-Quiroz Katia Vanessa, De La O-Espinoza Estivaliz Arizel, Serrano-Pérez Nancy Haydée, Ramírez-Jiménez Fernando, Teran Luis M
Department of Immunogenetics and Allergy, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico.
Laboratory of Human Leukocyte Antigen, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico.
J Asthma Allergy. 2023 Sep 6;16:937-950. doi: 10.2147/JAA.S418802. eCollection 2023.
To describe the lung function and clinical control of asthma in patients with N-ERD during three years of medical follow-up using GINA guidelines.
We evaluated 75 N-ERD and 68 asthma patients (AG). Clinical control, lung function, and asthma treatment were evaluated according to GINA-2014. We compared all variables at baseline and one, two, and three years after treatment.
At baseline, the N-ERD group had better basal lung function (LF) than the AG group (<0.01), and the AG group used higher doses of inhaled corticosteroids than the N-ERD group (52.4% vs 30.5%, =0.01) and short-term oral corticosteroid (OCS) use (52.4% vs 30.5%, <0.01). Instead, N-ERD patients needed more use of leukotriene receptor antagonists (LTRA) (29.3% vs 5.9%, <0.01). This group had better clinical control than the AG group (62.1% vs 34.1%, <0.01). During the medical follow-up, the LF of the N-ERD group remained at normal values; however, these parameters improved in AG from one year (<0.01). Likewise, there was a diminished use of high doses of ICS (52.4% vs 33%, <0.05) and short-term OCS (67.6% vs 20.6%, <0.01) in asthma patients. However, N-ERD patients still needed more use of LTRAs (<0.02) during the study. In this context, one-third of N-ERD patients had to use a combination of two drugs to maintain this control. From the second year on, clinical control of asthma was similar in both groups (>0.05).
According to GINA guidelines, only one-third of patients with N-ERD can gradually achieve adequate lung function and good asthma control with a high ICS dosage. Only a very small portion of patients will require the continued use of a second medication as an LTRA to keep their asthma under control.
采用全球哮喘防治创议（GINA）指南描述难治性嗜酸粒细胞性鼻炎（N-ERD）患者在三年医学随访期间的肺功能及哮喘临床控制情况。
我们评估了75例N-ERD患者和68例哮喘患者（AG）。根据GINA-2014对临床控制、肺功能及哮喘治疗进行评估。我们比较了治疗基线及治疗后1年、2年和3年的所有变量。
基线时，N-ERD组的基础肺功能（LF）优于AG组（P<0.01），AG组吸入性糖皮质激素（ICS）的使用剂量高于N-ERD组（52.4%对30.5%，P =0.01），短期口服糖皮质激素（OCS）的使用比例也高于N-ERD组（52.4%对30.5%，P<0.01）。相反，N-ERD患者白三烯受体拮抗剂（LTRA）的使用频率更高（29.3%对5.9%，P<0.01）。该组的临床控制情况优于AG组（62.1%对34.1%，P<0.0
