medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-18-40-48medsovet-7118Research ArticleХРОНИЧЕСКИЕ ЗАБОЛЕВАНИЯ ЛЕГКИХCHRONIC PULMONARY DISEASESБронхиальная астма: фокус на приверженность ингаляционной терапииBronchial asthma: focus on adherence to inhaled therapyhttps://orcid.org/0000-0003-0078-4071ФесенкоО. В.FesenkoO. V.

Фесенко Оксана Вадимовна, доктор медицинских наук, доцент, профессор кафедры пульмонологии

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Oxana V. Fesenko, Dr. Sci. (Med.), Associate Professor, Professor of Pulmonology Department

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

ofessenko@mail.ruРоссийская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuous Professional EducationRussian Federation20221410202216184048Copyright © Фесенко О.В., 20222022Фесенко О.В.Fesenko O.V.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/7118

Растущая заболеваемость, тяжелые обострения, риски летального исхода делают бронхиальную астму актуальной проблемой здравоохранения. Эффективный контроль заболевания признан главной целью современной терапии. Исследования, проведенные в нашей стране и за рубежом, демонстрируют низкий уровень контроля бронхиальной астмы у большинства больных. Важным условием достижения контроля является приверженность больного терапии. Более высокие показатели приверженности лечению и, как следствие, повышение качества жизни зафиксировано у пациентов, получающих базисную терапию, предусматривающую однократную в  течение дня ингаляцию. Комбинированный порошковый ингалятор длительного действия флутиказона фуроат /вилантерол является одним из современных препаратов, доказавших свою эффективность и безопасность. Препарат продемонстрировал достоверное улучшение функции легких и снижение частоты обострений астмы. Особого внимания заслуживают результаты рандомизированного клинического исследования, выполненного в  реальной (повседневной) клинической практике. Это форма исследования характеризуется неизбирательностью, т.  е. включением широкой группы больных независимо от  степени тяжести, сопутствующих заболеваний и образа жизни. Данный подход был использован в исследовании, получившем название «Солфордское исследование легких». В него включались пациенты, страдающие бронхиальной астмой и получающие постоянную поддерживающую терапию ингаляционными глюкокортикостероидами или их комбинациями из  центров первичной медико-санитарной помощи. Исследование продолжалось в течение 52 нед. В первую группу вошли пациенты, проводившие лечение комбинацией флутиказона фуроатом/вилантеролом. Больные 2-й группы продолжали получать исходную базисную терапию. Лучший ответ наблюдался при лечении комбинацией флутиказона фуроата/вилантерола. Он сохранялся во всех подгруппах, в которых проводился анализ, и не зависел от статуса курения, исходной степени снижения контроля, количества тяжелых обострений за последний год. Повышает приверженность лечению однократный прием и удобное, интуитивно простое средство доставки. Ингалятор требует минимальной координации, активируется одним движением и  снабжен понятным счетчиком доз.

The rising incidence of the disease, severe exacerbations, and risks of death make bronchial asthma an urgent public health problem. Effective control of the disease is recognised as the main goal of modern therapy. Studies conducted in our country and abroad show a low level of bronchial asthma control in most patients. An important condition for achieving control is the patient’s adherence to therapy. Higher adherence rates and, consequently, improved quality of life have been recorded in patients receiving baseline therapy, which involves a single inhalation per day. The long-acting combination powder inhaler fluticasone furoate/ vilanterol is one of the modern drugs with proven efficacy and safety. The drug has been shown to significantly improve lung function and reduce the frequency of asthma exacerbations. Of particular note are the results of a randomised clinical trial carried out in real (everyday) clinical practice. This form of study is non-selective, i.e. it includes a wide group of patients regardless of severity, comorbidities and lifestyle. This approach was used in a study called the Salford Lung Study. It included patients with bronchial asthma who were receiving ongoing maintenance therapy with inhaled glucocorticosteroids or combinations thereof from primary care centres. The study lasted for 52 weeks. The first group consisted of patients treated with the fluticasone furoate/vilanterol combination. Group 2 patients continued to receive baseline therapy. The best response was observed with the fluticasone furoate/vilanterol combination. It was maintained in all subgroups analyzed and was independent of smoking status, baseline control reduction, and number of severe exacerbations in the past year. Adherence to treatment is improved by a single dose and a convenient, intuitive means of delivery. The inhaler requires minimal coordination, is activated with a single movement and has an easy-to-understand dose counter.

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