medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2019-15-29-36medsovet-5228Research ArticleБронхиальная астмаBronchial asthmaЛегкая бронхиальная астма: современная концепция леченияMild bronchial asthma: a modern treatment concepthttps://orcid.org/0000-0002-8574-6869ЕмельяновА. В.Emel’yanovA. V.

д.м.н., профессор, заведующий кафедрой пульмонологии,

191015, Санкт-Петербург, ул. Кирочная, д. 41

Dr. of Sci. (Med), Professor, Head of the Department of Pulmonology, 

41, Kirochnaya St., St. Petersburg, 191015

aleksandr.emelyanov@szgmu.ruhttps://orcid.org/0000-0003-4616-3166ЛешенковаЕ. В.LeshenkovaE. V.

к.м.н., доцент кафедры пульмонологии,

191015, Санкт-Петербург, ул. Кирочная, д. 41

Cand. of Sci. (Med), Associate Professor of the Department of Pulmonology,

41, Kirochnaya St., St. Petersburg, 191015

leshenkova@mail.ruhttps://orcid.org/0000-0003-1544-4336СергееваГ. Р.SergeyevaG. R.

к.м.н., доцент кафедры пульмонологии,

191015, Санкт-Петербург, ул. Кирочная, д. 41

Cand. of Sci. (Med), Associate Professor of the Department of Pulmonology,

41, Kirochnaya St., St. Petersburg, 191015

sergeevagr@mail.ruСеверо-Западный государственный медицинский университет имени И.И. МечниковаРоссияNorth-Western State Medical University named after I.I. MechnikovRussian Federation2019051220190152936Copyright © Емельянов А.В., Лешенкова Е.В., Сергеева Г.Р., 20192019Емельянов А.В., Лешенкова Е.В., Сергеева Г.Р.Emel’yanov A.V., Leshenkova E.V., Sergeyeva G.R.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/5228

Легкая бронхиальная астма (БА) встречается у 50–75% пациентов с этим заболеванием. Она характеризуется клиническими симптомами, контроль которых осуществляется при использовании низких доз ингаляционных глюкокортикоидов (ИГКС) или антилейкотриеновых препаратов. Легкая БА снижает качество жизни больных, сопровождается развитием тяжелых, в ряде случаев смертельных, обострений, и характеризуется значительной стоимостью лечения. Одна из основных проблем ведения пациентов с этим заболеванием заключается в их низкой приверженности лечению ИГКС и чрезмерном использовании b2-адреномиметиков короткого действия. В нескольких клинических исследованиях показано, что использование комбинации будесонид/формотерол (Симбикорт® Турбухалер®) в режиме «по потребности» снижает частоту тяжелых обострений легкой БА так же, как низкие дозы будесонида, и характеризуется меньшей кумулятивной дозой этого глюкокортикоида. Полученные результаты явились основанием для создания новой концепции лечения, отдающей предпочтение комбинации ИГКС/формотерол «по требованию» при легкой БА как в качестве поддерживающей терапии, так и для купирования симптомов болезни.

Mild bronchial asthma (BA) occurs in 50–75% of patients with this disease. It is characterized by clinical symptoms that are controlled by low doses of inhaled glucocorticoids (IGCS) or anti-leukotriene drugs. Mild BA reduces the quality of life of patients, is accompanied by the development of severe, in some cases fatal exacerbations, and is characterized by a significant cost of treatment. One of the main problems in the management of patients with this disease is their low adherence to IGCS treatment and the excessive use of short-acting 2-adrenomimetic agents. Several clinical studies have shown that the use of a combination of budesonide/formoterol (Symbicort® Turbuhaler®) in an «as needed» mode reduces the incidence of severe exacerbations of mild BA as well as low doses of budesonide, and is characterized by a lower cumulative dose of this glucocorticoid. The results obtained were the basis for the creation of a new treatment concept, which gives preference to the combination of IGCS / formoterol «as needed» in mild BA as a supporting therapy, and for the management of symptoms of the disease.

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