Evaluation of treatment pattern with Global Initiative for Asthma (GINA) guidelines in patients of bronchial asthma

2019 ◽  
Vol 10 (3) ◽  
pp. 28-32
Author(s):  
Shreyas Ramchandra Burut ◽  
◽  
Ruchi Doongarshi Shah ◽  
Ramchandra B. Burute ◽  
Sunita Jaiprakash Ramanand ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Treatment Pattern ◽  
Global Initiative For Asthma ◽  
Global Initiative ◽  
Gina Guidelines

Bronchial asthma: fundamental changes in the new GINA guidelines (2019)

2020 ◽  
pp. 46-50
Author(s):  
Aleksey Vodovozov ◽  
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Evidence Base ◽  
Quality Level ◽  
Global Initiative For Asthma ◽  
Adequate Quality ◽  
Global Initiative ◽  
Common Clinical Practice ◽  
New Guidelines ◽  
Gina Guidelines

The new guidelines of the Global Initiative for Asthma (GINA) has inspired a heated discussion among experts. The next version was published in 2018, but its revision appeared as early as in 2019. This is primarily due to the revision of the attitude towards short-acting beta-2-agonists, however, the approaches have changed significantly at other stages of bronchial asthma treatment as well, especially at the early stages. The emphasis has been placed on low-dose inhaled corticosteroids, as they have accumulated an evidence base at an adequate quality level. In fact, the 2019 GINA proposals are reduced to discontinuation of the common clinical practice and switching to fundamentally different approaches to the management of bronchial asthma, especially its mild form.

scholarly journals Assessment of Asthma Control and Severity among Children According to Global Initiative for Asthma Guidelines in Sulaimani City-Iraq

2016 ◽  
Vol 12 (3) ◽  
pp. 160
Author(s):  
Adnan M. H. Hamawandi ◽  
Kosar M Ali ◽  
Ali Z. Naji
Keyword(s):  
Asthma Control ◽  
Objective Assessment ◽  
Asthma Management ◽  
Persistent Asthma ◽  
Cross Sectional ◽  
Asthmatic Children ◽  
Global Initiative For Asthma ◽  
Severe Persistent Asthma ◽  
Global Initiative ◽  
Gina Guidelines

Background: Asthma is a common and potentially serious chronic disease that imposes a substantial burden on patients, their families and the community. Objective: Assessment of the level of asthma control and severity in asthmatic children in Sulaimani city according to the global initiative for asthma (GINA) guidelines. Methods: A cross-sectional study of 82 patients who are known cases of asthma, aged 5 – 15 years , from 1st of March 2014 to 1st of August 2014. Results: Out of 82 patients in our study, 20.8%were classified as having intermittent asthma all of them have well controlled asthma, 42.7% of those classified as having mild persistent asthma 65.7% of them have well controlled asthma, 26.8% of those classified as having moderate persistent asthma 54.5% of them have partly controlled asthma, and 9.8%of those classified as having severe persistent asthma the majority of them 87.5% have uncontrolled asthma and none of them reached to the controlled asthma level according to GINA guidelines. Regarding the peak expiratory flow (PFT) we notice that 58.8% of asthmatic children who were classified as having intermittent severity, their PEF measurements ranged between 160- 250 l/min while those with severe persistent asthma 75% of them have readings between 50-150 l/min. Conclusion: Current levels of asthma control in the Sulaimani city fall far short of the goals specified in the GINA guidelines for asthma management. Also there is a strong correlation between PEF measurements and the level of asthma severity,

scholarly journals Tiotropium bromide: additional options for the treatment of bronchial asthma

2019 ◽  
Vol 16 (3) ◽  
pp. 67-74
Author(s):  
O M Kurbacheva ◽  
M E Dyneva
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Biological Properties ◽  
Additional Treatment ◽  
Tiotropium Bromide ◽  
Inhalation Therapy ◽  
Global Initiative For Asthma ◽  
Successful Control ◽  
Global Initiative ◽  
Long Acting

Bronchial asthma (BA) is one of the most common chronic diseases, characterized by airway inflammation and bronchospasm. Symptoms of BA are wheezing, shortness of breath, a feeling of constriction in the chest and cough, the frequency and severity of which vary greatly over time. Today studies of BA phenotypes allow selecting treatment depending on the particular pathogenesis of each phenotype individually, thereby helping to achieve control, which is the main goal of BA therapy. However, it is necessary to take into account the peculiarities of airway innervation, since an increased parasympathetic tone is characteristics of all BA phenotypes and plays an important role in the development of bronchoconstriction and inflammation. Therefore, tiotropium bromide, which is a long-acting blocker of muscarinic cholinergic receptors, is one of the main bronchodilators in the treatment of BA. It blocks bronchoconstriction, hypersecretion and swelling of the mucous membrane of the airway, which in turn prevents the progression of inflammation, and the prolonged action of tiotropium bromide, which allows it to be used once a day helps to achieve control of asthma in addition to basic inhalation therapy - inhaled corticosteroids (ICS) long-acting P2-agonists (LABA). According to GINA (Global Initiative for Asthma), tiotropium bromide is recommended as an additional treatment, starting from step 4, and in accordance with the Russian Federal Clinical Guidelines for Bronchial Asthma - from step 3. Currently, according to clinical studies, much is known about the mechanisms of action and biological properties of tiotropium bromide, which made it possible to substantiate the needs for its administration to patients with BA regardless of its phenotype. This strategy will contribute to a more successful control of BA considering risk factors and comorbidity, thereby reducing needs of increasing ICS dose.

ТИОТРОПИЯ БРОМИД: ДОПОЛНИТЕЛЬНЫЕ ВОЗМОЖНОСТИ ДЛЯ ЛЕЧЕНИЯ БРОНХИАЛЬНОЙ АСТМЫ

2019 ◽  
pp. 67-74
Author(s):  
O.M. Kurbacheva ◽  
M.E. Dyneva
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Biological Properties ◽  
Additional Treatment ◽  
Tiotropium Bromide ◽  
Inhalation Therapy ◽  
Global Initiative For Asthma ◽  
Successful Control ◽  
Muscarinic Cholinergic ◽  
Global Initiative

Бронхиальная астма (БА) это одно из наиболее распространенных хронических заболеваний, характеризующееся воспалением дыхательных путей (ДП) и бронхоспазмом. Симптомами БА являются хрипы, одышка, ощущение сдавливания в грудной клетке и кашель, частота и степень тяжести которых сильно варьируют с течением времени. На сегодняшний день изучение фенотипов БА позволяет подбирать лечение в зависимости от особенностей патогенеза каждого фенотипа в отдельности, тем самым помогая достичь контроля, что является основной целью терапии БА. Однако необходимо учитывать особенности иннервации ДП, так как повышенный парасимпатический (холинергический) тонус характерен для всех фенотипов БА и играет важную роль в развитии бронхоконстрикции и воспаления. Поэтому тиотропия бромид, являющийся блокатором мускариновых холинорецепторов длительного действия, один из основных бронхолитических препаратов в лечении БА. Он блокирует развитие бронхоконстрикции, гиперсекреции и отека слизистой оболочки ДП, что в свою очередь предотвращает прогрессирование воспаления, а продолжительное действие тиотропия бромида, позволяющее применять его один раз в сутки, помогает обеспечивать контроль БА на фоне базисной ингаляционной терапии ингаляционные глюкокортикостероиды (ИГКС)/Р2агонисты длительного действия (ДДБА). Согласно GINA (Global Initiative for Asthma Глобальная стратегия лечения и профилактики бронхиальной астмы), тиотропия бромид рекомендован в качестве дополнительного лечения, начиная с 4й ступени, а в соответствии с Федеральными клиническими рекомендациями по бронхиальной астме (2018) с 3й ступени. В настоящее время благодаря проведенным клиническим исследованиям многое известно о механизмах действия и биологических свойствах тиотропия бромида, что позволило обосновать необходимость его назначения пациентам с БА независимо от ее фенотипа. Эта стратегия будет способствовать более успешному контролю БА с учетом факторов риска и сопутствующей патологии, тем самым снижая необходимость в увеличении дозы ИГКС.Bronchial asthma (BA) is one of the most common chronic diseases, characterized by airway inflammation and bronchospasm. Symptoms of BA are wheezing, shortness of breath, a feeling of constriction in the chest and cough, the frequency and severity of which vary greatly over time. Today studies of BA phenotypes allow selecting treatment depending on the particular pathogenesis of each phenotype individually, thereby helping to achieve control, which is the main goal of BA therapy. However, it is necessary to take into account the peculiarities of airway innervation, since an increased parasympathetic tone is characteristics of all BA phenotypes and plays an important role in the development of bronchoconstriction and inflammation. Therefore, tiotropium bromide, which is a longacting blocker of muscarinic cholinergic receptors, is one of the main bronchodilators in the treatment of BA. It blocks bronchoconstriction, hypersecretion and swelling of the mucous membrane of the airway, which in turn prevents the progression of inflammation, and the prolonged action of tiotropium bromide, which allows it to be used once a day helps to achieve control of asthma in addition to basic inhalation therapy inhaled corticosteroids (ICS) longacting P2agonists (LABA). According to GINA (Global Initiative for Asthma), tiotropium bromide is recommended as an additional treatment, starting from step 4, and in accordance with the Russian Federal Clinical Guidelines for Bronchial Asthma from step 3. Currently, according to clinical studies, much is known about the mechanisms of action and biological properties of tiotropium bromide, which made it possible to substantiate the needs for its administration to patients with BA regardless of its phenotype. This strategy will contribute to a more successful control of BA considering risk factors and comorbidity, thereby reducing needs of increasing ICS dose.

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