National Jewish Medical and Research Center
Reprinted from the Journal of Allergy and Clinical Immunology, 2001; 107: 397-416 with kind permission of Mosby, Inc.
Tłumaczenie: dr med. Barbara Bieńkiewicz
Several classes of medications are available for the treatment of asthma, and often they must be taken concurrently to achieve asthma control. Based on the understanding of asthma as an innammatory disease, the National Heart Lung and Blood Institute guidelines provide a stepwise approach to pharmacologic therapy. Corticosteroid therapy, principally inhaled corticosteroid (ICS) therapy, is considered the most effective anti- innammatory treatment. In cases of moderate-to-severe persistent asthma, the addition of a second long-term control medication to ICS therapy is one recommended treatment option. A combination-product inhaler (Advair, Seretide) was developed to treat both the innammatory and bronchoconstric. tive components of asthma by delivering a dose of the ICS, nu- ticasone propionate, and a dose of the long-acting b2-adrenergic (LABA) bronchodilator, salmeterol. The Advair Diskus is available in 3 strengths of nuticasone propionate (100, 250, and 500 µg) and a fixed dose (50 µg) of salmeterol. Combination treat. ment with both ICS and LABA provides greater asthma control than increasing the ICS dose alone, while at the same time reducing the frequency and perhaps the severity of exacerbations. Furthermore, salmeterol added to ICS therapy provides superior asthma control compared with the addition of leukotriene modifiers or theophylline. The superior control is likely a consequence of the complementary actions of the drugs when taken together, including the activation of the glucocorti- coid receptor by salmeterol. By combining anti-infammatory treatment with a long.acting b2-agonist in a single inhaler (1 inhalation twice daily), physicians can provide coverage for both the innammatory and bronchoconstrictive aspects of asthma without introducing any new or unexpected adverse consequences. The most common drug-related adverse events were those known to be attributable to the constituent medications (ICS therapy and/or LABA therapy). Although the benefits of combined ICS plus LABA therapy can be achieved with separate inhalers, the convenience of the combination product may improve patient adherence and may therefore reduce the morbidity of asthma. (J Allergy Clin Immunol 2001; 107: 397-416.)
Alergia Astma Immunologia, 2002; 7(4): 183-203
keywords: astma, Advair (Seretide), salmeterol, propionian flutikazonu, terapia łączona, Seretide, leki przeciwleukotrienowe, zaostrzenie, Serevent, Flovent, asthma, Advair (Seretide), salmeterol, fluticasone propionate, combination therapy, Seretide, leukotriene m
pages: from 183 to 203
|estimated time of download (246 kB)|