scholarly journals ASMANEX TWISTHALER - THE DRUG OF CHOICE AMONG INHALED CORTICOSTEROIDS

2013 ◽  
Vol 10 (6) ◽  
pp. 51-57
Author(s):  
T V Latysheva ◽  
E A Latysheva ◽  
O V Shubina
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Control Methods ◽  
Efficacy And Safety ◽  
Prior Therapy ◽  
Asthma Symptoms ◽  
Drug Of Choice ◽  
Systemic Corticosteroids ◽  
Before And After ◽  
Baseline Therapy

Goals. To reveal the clinical efficacy and safety of Asmanex in patients with moderate and severe bronchial asthma (BA), treated with inhaled and/or systemic glucocorticosteroids (GCS), depending on the severity and level of control. Methods. 40 patients (age 18 to 65 years) were treated with Asmanex with equivalent to prior therapy with inhaled corticosteroids (ICS) doses or in combination with systemic corticosteroids prior therapy (without increasing the dose of systemic corticosteroids) for 3 months. Efficacy was assessed before and after the treatment on a background of Asmanex treatment by the need of additional using of agonists of β 2-adrenoreceptors, severity of daytime and nighttime asthma symptoms, dynamics of spirometry parameters. The efficacy of Asmanex was compared with the original baseline therapy of other inhaled corticosteroids at equivalent doses using the new delivery system.

АНТИ-IGE ТЕРАПИЯ ТЯЖЕЛОЙ АТОПИЧЕСКОЙ БРОНХИАЛЬНОЙ АСТМЫ

2019 ◽  
Author(s):  
N.P. Knyazheskaya ◽  
A.S. Belevskiy ◽  
E.V. Safoshkina
Keyword(s):  
Inhaled Corticosteroids ◽  
Positive Impact ◽  
Atopic Asthma ◽  
Level Of Evidence ◽  
Systemic Corticosteroids ◽  
Steroid Dependent ◽  
Stage 4 ◽  
High Doses ◽  
Baseline Therapy ◽  
Inflammatory Effect

Первым таргетным (целевым) препаратом, который применяется у пациентов с неконтролируемой среднетяжелой и тяжелой бронхиальной астмой (БА), стал анти-IgE препарат омализумаб (Ксолар). Этот препарат назначается пациентам со среднетяжелой и тяжелой атопической БА, которая не контролируется базисной терапией, соответствующей ступени 4 (уровень доказательности А). Клинические исследования убедительно продемонстрировали, что у пациентов с тяжелой астмой, требующих терапии высокими дозами ингаляционных кортикостероидов или пероральными глюкокортикостероидами, лечение препаратом Ксолар снижает частоту обострений БА, уменьшает степень тяжести астмы и позволяет при стероидозависимой БА отменять или значительно снижать дозы системных кортикостероидов. Кроме того, доказан противовоспалительный эффект препарата. Исследования последних лет приводят все больше данных о положительном влиянии омализумаба на ремоделирование дыхательных путей.The first targeted drug that is used for patients with uncontrolled moderate and severe atopic asthma (BA) was anti-IgE drug omalizumab (Xolar). This drug is prescribed to patients with moderate to severe atopic BA, which is not controlled by baseline therapy corresponding to stage 4 (level of evidence A). Clinical studies have convincingly demonstrated that in patients with severe asthma requiring treatment with high doses of inhaled corticosteroids or oral glucocorticosteroids, treatment with Xolar reduces the frequency of exacerbations of BA, reduces the severity of asthma and allows for steroid-dependent BA to cancel or significantly reduce the dose of systemic corticosteroids. In addition, the anti-inflammatory effect of the drug has been proven. Studies in recent years provide more and more data on the positive impact of omalizumab on the remodeling of the respiratory tract.

scholarly journals Tiotropium: efficacy and safety in pediatric bronchial asthma

2021 ◽  
pp. 175-180
Author(s):  
Natalia G. Kolosova ◽  
Irina V. Grebeneva ◽  
Veronika D. Denisova
Keyword(s):  
Children And Adolescents ◽  
Bronchial Asthma ◽  
Adjunctive Therapy ◽  
Randomized Clinical Trials ◽  
Inhaled Corticosteroids ◽  
Symptom Control ◽  
Asthma Treatment ◽  
Efficacy And Safety ◽  
Chronic Lung Diseases ◽  
Long Acting

Bronchial asthma is one of the most common chronic lung diseases observed in children. According to the international and Russian guidelines, the long-term objectives of asthma treatment in children and adolescents are to achieve good symptom control, minimize the risk of asthma exacerbations, reduce hospital admissions, decrease the use of short-acting bronchodilators, reduce restrictions in the airflow and side effects, and ensure that normal activity levels are maintained. The asthma treatment is based on the use of inhaled corticosteroids as a backbone therapy and addition of adjunctive therapy if the disease control is poor or worsening. Tiotropium bromide is the first anticholinergic drug that has been approved for children and adults with poorly controlled asthma and is currently used as a treatment option for moderate to severe bronchial asthma. Randomized clinical trials in children and adolescents with persistent bronchial asthma showed high efficacy and safety of tiotropium. The addition of tiotropium in the form of 2 inhalations of 2.5 μg once a day to the bronchial asthma therapy in children over 6 years old, including medium doses of inhaled corticosteroids, is a preferred and safe option to increase the therapy coverage compared to an increase of a dose of inhaled corticosteroids to high levels, regardless of the disease phenotype (In atopic, non-atopic bronchial asthma, bronchial asthma with obesity, etc.). Tiotropium adjunctive therapy may also be a therapeutic option for children using inhaled corticosteroids, who have asthma that does not respond well to long-acting β2-agonist therapy, or for those, who are worried about the safety of long-acting β2-agonists.

scholarly journals Effect of CYP3A5*3 polymorphism on anti-inflamatory therapy in children with bronchial asthma

2019 ◽  
pp. 146-151
Author(s):  
A. K. Zastrozhina ◽  
S. V. Zaitseva ◽  
E. A. Grishina ◽  
K. A. Ryzhykova ◽  
O. O. Panfeorova ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Statistical Data ◽  
Inhaled Corticosteroids ◽  
Dynamic Assessment ◽  
Polymorphic Marker ◽  
Asthma Therapy ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Children With Asthma ◽  
Cyp3a5 Gene

Previous pharmacogenetic studies demonstrate significant genes’ polymorphisms effect on the efficacy and safety of pharmacotherapy, including in bronchial asthma (BA). According to the literature, there are data on the effect of polymorphisms CYP3A4*22 and CYP3A5*3 on the efficacy of inhaled corticosteroids in children with BA. Further research on the effect of pharmacogenetic features on the efficacy and safety of drugs is one of the way to optimize asthma therapy in children.Purpose. Identification of possible ways to optimize asthma therapy by the analysis of CYP3A5 (A6986G) gene polymorphism effect on the asthma therapy efficacy.Materials and methods. The study was conducted on the basis of three children’s polyclinics of Moscow. 100 children aged 6–17 years with an established diagnosis of BA were included. Dynamic assessment of asthma control and the amount of therapy needed was carried out. All patients underwent genotyping for the A6986G polymorphism of CYP3A5 gene by real-time PCR. Statistical data analysis was carried out using a programming language for statistical data processing R.3.4.0.Results. It was found that 8% of children with asthma were heterozygous for the A6986G polymorphism of the CYP3A5 gene, 92% of respondents were homozygous with the GG genotype. In 6 out of 8 heterozygotes, the amount of control therapy corresponded the third and fourth therapy stages according to GINA criteria. In the group of moderate and severe BA, the number of heterozygotes for the A6986G polymorphic marker of the CYP3A5 gene was statistically higher compared to the group of children with mild BA (p = 0,048).Conclusion. Thus, we identified a statistically significant difference in the occurrence of heterozygotes for the A6986G polymorphism of the CYP3A5 gene between groups of children with mild asthma and patients with moderate and severe asthma. The AG genotype and the presence of the A allele (CYP3A5 gene (A6986G)) are associated with more severe BA and the need for more anti-inflammatory therapy.

scholarly journals Anti-IgE therapy for severe atopic asthma

2019 ◽  
Vol 16 (1) ◽  
pp. 71-78
Author(s):  
N P Knyazheskaya ◽  
A S Belevskiy ◽  
E V Safoshkina
Keyword(s):  
Inhaled Corticosteroids ◽  
Positive Impact ◽  
Atopic Asthma ◽  
Level Of Evidence ◽  
Systemic Corticosteroids ◽  
Steroid Dependent ◽  
Stage 4 ◽  
High Doses ◽  
Baseline Therapy ◽  
Inflammatory Effect

The first targeted drug that is used for patients with uncontrolled moderate and severe atopic asthma (BA) was anti-IgE drug omalizumab (Xolar®). This drug is prescribed to patients with moderate to severe atopic BA, which is not controlled by baseline therapy corresponding to stage 4 (level of evidence A). Clinical studies have convincingly demonstrated that in patients with severe asthma requiring treatment with high doses of inhaled corticosteroids or oral glucocorticosteroids, treatment with Xolar® reduces the frequency of exacerbations of BA, reduces the severity of asthma and allows for steroid-dependent BA to cancel or significantly reduce the dose of systemic corticosteroids. In addition, the anti-inflammatory effect of the drug has been proven. Studies in recent years provide more and more data on the positive impact of omalizumab on the remodeling of the respiratory tract.

scholarly journals Compare the Effect of Inhaled Corticosteroids and Systemic Corticosteroids on Sputum Microbiome of AECOPD

2021 ◽  
Vol 8 ◽  
Author(s):  
Nan Ma ◽  
Yujing Qi ◽  
Xiaona Liang ◽  
Jing Bai ◽  
Jingmin Deng ◽  
...  
Keyword(s):  
Bacterial Abundance ◽  
Inhaled Corticosteroids ◽  
Alpha Diversity ◽  
Shannon Index ◽  
Diversity Analysis ◽  
Linear Discriminant ◽  
Genus Level ◽  
Systemic Corticosteroids ◽  
Significant Difference ◽  
Before And After

Background: To observe the effects of inhaled corticosteroids (ICS) and systemic corticosteroids (SCS) on the sputum microbiology of patients with AECOPD.Methods: The 16S rRNA sequencing results for sputum samples from 36 admitted AECOPD patients were analyzed using ICS or SCS on the basis of standard treatment; sputum samples were collected before and after treatment for 1 day, 7, and 14 days.Results: After 7 days of SCS treatment, the bacterial abundance of Sorangium, Acidibacter, and Fretibacterium decreased at the genus level. After 14 days of SCS treatment, the bacterial abundance of Prevotella_2, Bergeyella, Corynebacterium_1, and Ruminococcaceae_UCG-014 was decreased at the genus level, and an increase in the bacterial abundance of the Clostridiales_vadinBB60_group was observed at the family level. The linear discriminant analysis effect size (LEfSe) algorithm showed that after treatment for 14 days, Sphingobacterium increased in the SCS group, and Corynebacterium_1 (genus level), Bacillales (order level), and Lactobacillales (order level) decreased in the ICS group. However, the abundance of the above bacteria in each group of samples was <1%, suggesting that the two treatments may have similar effects on bacterial abundance. Alpha diversity analysis results showed that there was no significant difference in the ACE index, Chao1 index, Shannon index, or Simpson index between the ICS group and the SCS group. Beta diversity analysis showed that there was little difference in bacterial diversity among each group. BugBase predicted that although bacteria containing mobile elements in the SCS group decreased significantly compared with those in patients using ICS after treatment for 14 days, these two treatments had similar effects on other phenotype categories assigned to the bacterial contents.Conclusions: Our results show that ICS and SCS have remarkably similar effects on the sputum microbiome of AECOPD patients.

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