medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2016-15-33-40medsovet-1560Research ArticleБронхиальная астмаBronchial asthmaНОВЫЕ ВОЗМОЖНОСТИ ТЕРАПИИ ЛЕГКОЙ БРОНХИАЛЬНОЙ АСТМЫNEW POSSIBILITIES OF MILD BRONCHIAL ASTHMA THERAPYНЕНАШЕВАН. М.NENASHEVAN. M.

д.м.н., профессор

Москва

 

DM, Prof.

Российская медицинская академия последипломного образованияРоссияSBEI APE Russian Medical Academy of Post-Graduate EducationRussian Federation2016301220160153340Copyright © НЕНАШЕВА Н.М., 20162016НЕНАШЕВА Н.М.NENASHEVA N.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/1560

В структуре бронхиальной астмы (БА) легкая форма болезни занимает ведущее место – от 50 до 75% больных страдают легкой астмой. Своевременная диагностика заболевания у этих пациентов и адекватное лечение позволяют предотвратить прогрессирование болезни. В настоящей статье обсуждаются вопросы определения тяжести БА, распространенность, бремя и стандартные подходы к терапии легкой БА. Особое внимание уделено новой возможности лечения легкой астмы у взрослых пациентов с помощью комбинированного препарата сальбутамол/беклометазон, представленного в виде дозированного аэрозольного ингалятора и предназначенного для купирования симптомов и постоянного лечения БА и хронической обструктивной болезни легких (ХОБЛ) у взрослых с 18 лет. Применение фиксированной комбинации сальбутамол/беклометазон в режиме «по требованию» у взрослых больных легкой астмой приводит к увеличению времени до первого обострения и снижению числа обострений заболевания, при этом сопровождается минимальной кумулятивной дозой ингаляционного кортикостероида и позволяет преодолеть низкую приверженность пациентов лечению ИГКС.

In the bronchial asthma structure the mild form of the disease takes the leading place: from 50 to 75% of patients suffer from mild asthma. Modern diagnostics of disease in these patients and adequate therapy allow preventing the disease progress. This article discusses issues of determination of the bronchial asthma gravity, incidence rate, disease burden and standard approaches to therapy of the mild bronchial asthma. Particular attention is given to a new possibility of therapy of mild asthma in adult patients with the help of the combined drug Salbutamol/Beclomethazone represented in the form of an aerosol inhaler and intended for arrest of symptoms and permanent therapy of bronchial asthma and chronic obstructive pulmonary disease in adults from the age of 18. Use of fixed combination Salbutamol/Beclomethazone in the regime “on demand” in adult patients with mild bronchial asthma leads to increase of the time to the first exacerbation and reduction of the disease exacerbations, at the same time it is accompanied by the minimum cumulative dosage of the inhalation corticosteroid and allows overcoming the low commitment of patients to therapy by inhalation corticosteroids.

тяжесть астмылегкая бронхиальная астматерапия легкой астмыфиксированная комбинация сальбутамол/беклометазон дипропионатasthma gravitymild bronchial asthmatherapy of mild asthmafixed combination Salbutamol/ Beclomethasone DipropionateReferencesTo T, Stanojevic S, Moores G, Gershon A, Bateman E et al. Global asthma prevalence in adults: findings from the cross-sectional world health survey. BMC Public Health, 2012. DOI: 10.1186/1471-2458-12-204.To T, Stanojevic S, Moores G, Gershon A, Bateman E et al. Global asthma prevalence in adults: findings from the cross-sectional world health survey. BMC Public Health, 2012. DOI: 10.1186/1471-2458-12-204.Chuchalin AG, Khaltaev N, Аntonov N. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation International Journal of COPD 2014, 9: 963–974.Chuchalin AG, Khaltaev N, Аntonov N. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation International Journal of COPD 2014, 9: 963–974.Национальная программа «Бронхиальная астма у детей. Стратегия лечения и профилактика», IV издание. М., 2012. 182 с.Национальная программа «Бронхиальная астма у детей. Стратегия лечения и профилактика», IV издание. М., 2012. 182 с.GINA 2008, www.ginasthma.org.GINA 2008, www.ginasthma.org.GINA 2016, www.ginasthma.org.GINA 2016, www.ginasthma.org.Rabe KF, Adachi M, Lai CK, Soriano JB, Vermeire PA, Weiss KB et al. Worldwide severity and control of asthma in children and adults: the global asthma insights and reality surveys. J Allergy Clin Immunol, 2004, 114: 40–47.Rabe KF, Adachi M, Lai CK, Soriano JB, Vermeire PA, Weiss KB et al. Worldwide severity and control of asthma in children and adults: the global asthma insights and reality surveys. J Allergy Clin Immunol, 2004, 114: 40–47.Sadatsafavi M, Lynd L, Marra C et al. Direct health care costs associated with asthma in British Columbia. Can Respir J., 2010, 17(2): 74–80.Sadatsafavi M, Lynd L, Marra C et al. Direct health care costs associated with asthma in British Columbia. Can Respir J., 2010, 17(2): 74–80.Kauppi P, Peura S, Salimäki J, Järvenpää S, Linna M, Haahtela T. Reduced severity and improved control of self-reported asthma in Finland during 2001-2010. Asia Pac Allergy, 2015 Jan, 5(1): 32–39.Kauppi P, Peura S, Salimäki J, Järvenpää S, Linna M, Haahtela T. Reduced severity and improved control of self-reported asthma in Finland during 2001-2010. Asia Pac Allergy, 2015 Jan, 5(1): 32–39.Ненашева Н.М., Буриев Б.Б. Особенности атопической бронхиальной астмы у взрослых. Российский аллергологический журнал, 2009, 4: 12—17.Ненашева Н.М., Буриев Б.Б. Особенности атопической бронхиальной астмы у взрослых. Российский аллергологический журнал, 2009, 4: 12—17.Dusser D, Montani D, Chanez Р, De Blic J, Delacourt С et al. Mild asthma: an expert review on epidemiology, clinical characteristics and treatment recommendations. Allergy, 2007, 62(6): 591–604.Dusser D, Montani D, Chanez Р, De Blic J, Delacourt С et al. Mild asthma: an expert review on epidemiology, clinical characteristics and treatment recommendations. Allergy, 2007, 62(6): 591–604.Robertson CF, Rubinfield AR, Bowes G. Pediatric asthma deaths in Victoria: the mild are at risk. Pediatr Pulmonol., 1992, 13(2): 95–100.Robertson CF, Rubinfield AR, Bowes G. Pediatric asthma deaths in Victoria: the mild are at risk. Pediatr Pulmonol., 1992, 13(2): 95–100.Fuhlbrigge AL, Adams RJ, Guilbert TW, Grant E, Lozano P, Janson Sl et al. The burden of asthma in the United States: level and distribution are dependent on interpretation of the national asthma education and prevention program guidelines. Am J Respir Crit Care Med, 2002, 166: 1044–1049.Fuhlbrigge AL, Adams RJ, Guilbert TW, Grant E, Lozano P, Janson Sl et al. The burden of asthma in the United States: level and distribution are dependent on interpretation of the national asthma education and prevention program guidelines. Am J Respir Crit Care Med, 2002, 166: 1044–1049.Salmeron S, Liard R, Elkharrat D, Muir J, Neukirch F, Ellrodt A. Asthma severity and adequacy of management in accident and emergency departments in France: a prospective study. Lancet, 2001, 358: 629–635.Salmeron S, Liard R, Elkharrat D, Muir J, Neukirch F, Ellrodt A. Asthma severity and adequacy of management in accident and emergency departments in France: a prospective study. Lancet, 2001, 358: 629–635.Mitchell I, Tough SC, Semple LK, Green FH, Hessel PA. Near-fatal asthma: a population-based study of risk factors. Chest, 2002, 121: 1407–1413.Mitchell I, Tough SC, Semple LK, Green FH, Hessel PA. Near-fatal asthma: a population-based study of risk factors. Chest, 2002, 121: 1407–1413.Sailly JC, Lenne X, Bercez C, Lebrun T, Tonnel AB, Tillie-Leblond I. Costs of hospitalization for severe acute asthma of patients not treated according to guidelines and recommendations French prospective study of 169 cases. Eur J Health Econ, 2005, 6: 94–101.Sailly JC, Lenne X, Bercez C, Lebrun T, Tonnel AB, Tillie-Leblond I. Costs of hospitalization for severe acute asthma of patients not treated according to guidelines and recommendations French prospective study of 169 cases. Eur J Health Econ, 2005, 6: 94–101.Why Asthma still kills. The National Review of Asthma Deaths. 2014. www.rcpiondon.ac.uk.Why Asthma still kills. The National Review of Asthma Deaths. 2014. www.rcpiondon.ac.uk.Федеральные клинические рекомендации по диагностике и лечению бронхиальной астмы, 2016 www.pulmonology.ru.Федеральные клинические рекомендации по диагностике и лечению бронхиальной астмы, 2016 www.pulmonology.ru.Price D, Fletcher M, Thys van der Molen. Asthma control and management in 8,000 European patients: the REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey. NPJ Prim Care Respir Med, 2014, 12 (24): 14009. Epub 2014 Jun 12.Price D, Fletcher M, Thys van der Molen. Asthma control and management in 8,000 European patients: the REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey. NPJ Prim Care Respir Med, 2014, 12 (24): 14009. Epub 2014 Jun 12.Partridge MR, Dal Negro RW, Olivieri D. Understanding patients with asthma and COPD: insights from a European study. Prim Care Respir J, 2011, 20: 315–323.Partridge MR, Dal Negro RW, Olivieri D. Understanding patients with asthma and COPD: insights from a European study. Prim Care Respir J, 2011, 20: 315–323.Boushey H., Sorkness C, King T, Sullivan S, et al. Daily versus As-Needed Corticosteroids for Mild Persistent Asthma. N Engl J Med, 2005, 352: 1519–1528.Boushey H., Sorkness C, King T, Sullivan S, et al. Daily versus As-Needed Corticosteroids for Mild Persistent Asthma. N Engl J Med, 2005, 352: 1519–1528.Calhoun W, Ameredes B, King T, Icitovic N, Bleecker E, Castro M et al. Comparison of Physician-, Biomarker-, and Symptom-Based Strategies for Adjustment of Inhaled Corticosteroid Therapy in Adults With Asthma. The BASALT Randomized Controlled Trial. JAMA, 2012, 308(10): 987-997. DOI:10.1001/2012.jama.10893.Calhoun W, Ameredes B, King T, Icitovic N, Bleecker E, Castro M et al. Comparison of Physician-, Biomarker-, and Symptom-Based Strategies for Adjustment of Inhaled Corticosteroid Therapy in Adults With Asthma. The BASALT Randomized Controlled Trial. JAMA, 2012, 308(10): 987-997. DOI:10.1001/2012.jama.10893.Taylor DR, Sears MR, Herbison GP, Flannery EM, Print CG et al. Regular inhaled beta agonist in asthma: effects on exacerbations and lung function. Thorax, 1993 Feb, 48(2): 134–138.Taylor DR, Sears MR, Herbison GP, Flannery EM, Print CG et al. Regular inhaled beta agonist in asthma: effects on exacerbations and lung function. Thorax, 1993 Feb, 48(2): 134–138.Инструкция для применения препарата СабаКомб®.Инструкция для применения препарата СабаКомб®.Papi A, Canonica G, Maestrelli P, Paggiaro P, Olivieri D et al. Rescue Use of Beclomethasone and Albuterol in a Single Inhaler for Mild Asthma. N Engl J Med, 2007, 356: 2040–2052Papi A, Canonica G, Maestrelli P, Paggiaro P, Olivieri D et al. Rescue Use of Beclomethasone and Albuterol in a Single Inhaler for Mild Asthma. N Engl J Med, 2007, 356: 2040–2052

The authors declare that there are no conflicts of interest present.