The pharmacotherapy of professional serious bronchial asthma

Russian Journal of Occupational Health and Industrial Ecology ◽

10.31089/1026-9428-2019-59-9-576-577 ◽

2020 ◽

pp. 576-577

Author(s):

N. V. Vakurova ◽

T. A. Azovskova ◽

G. F. Vasukova

Keyword(s):

Bronchial Asthma ◽

Combined Therapy ◽

Tiotropium Bromide ◽

Severe Exacerbation ◽

Functional Parameters ◽

Long Acting

In patients with severe bronchial asthma (BA) of professional origin, with the additional appointment of Tiotropium bromide on the background of combined therapy with inhaled glucocorticosteroids and long-acting b2-agonists, functional parameters improve, the proportion of days with good BA control increases, the total number of exacerbations decreases and the period increases to the first severe exacerbation.

Download Full-text

THE EFFICACY AND SAFETY OF FOSTER IN PATIENTS WITH BRONCHIAL ASTHMA IN ROUTINE CLINICAL PRACTICEon behalf of the Research Group «ESTAFETA» to assess the efficacy and safety of the drug «Foster» in patients with asthma in routine clinical practice

Rossiiskii Allergologicheskii ZHurnal ◽

10.36691/rja922 ◽

2009 ◽

Vol 7 (5) ◽

pp. 82-90

Author(s):

N I Iljina ◽

K S Pavlova

Keyword(s):

Asthma Control ◽

Bronchial Asthma ◽

Fixed Combination ◽

Combined Therapy ◽

Persistent Asthma ◽

Innovative Technology ◽

Symptomatic Therapy ◽

Efficacy And Safety ◽

Inhaled Steroids ◽

Long Acting

Background. Evaluation of the efficacy and safety of the drug Foster (fixed combination of beclomethasone di-propionate 100 mcg and formoterol 6 micrograms per single dose) in metered-dose aerosol inhaler technology Modulite® in patients with bronchial asthma (BA). Methods. Prospective non comparative multicenter open observational study. Study group consisted of 120 practicing physicians from the 92 hospitals in 21 cities of Russia. Analyzed 557 case report forms of patients with moderate persistent asthma treated with Foster during 12 weeks who needed to correct the basic therapy (according to asthma control criteria GINA 2006). Results. The effectiveness of treatment with Foster was observed in 555 (99,6%) of 557 patients, who showed improvement in lung function, decreased severity of symptoms, reducing the need for symptomatic therapy compared with baseline and improved asthma control in general. Conclusions. In most cases, control over moderate and severe persistent asthma can be improved by the combined therapy of inhaled steroids (ICS) and в2-agonist long-acting (LABA). In this case, Foster is a drug of choice with a fixed combination of ICS and LABA. Extra-fine form of the drug (thanks to innovative technology Modulite®) is evenly distributed in central and peripheral airways, providing good therapeutic effect of using of low doses of ICS and reducing the likelihood of side effects.

Download Full-text

Tiotropium bromide: additional options for the treatment of bronchial asthma

Rossiiskii Allergologicheskii ZHurnal ◽

10.36691/rja1212 ◽

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.

Download Full-text

Influence of combined antihypertensive therapy on plasmatic,vascular-thrombocytic hemostasis and lipid peroxidation in patientswith metabolic syndrome and arterial hypertension

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2007-4-58-63 ◽

2007 ◽

Vol 6 (4) ◽

pp. 58-63

Author(s):

N. M. Krasnova ◽

E. A. Bushkova

Keyword(s):

Metabolic Syndrome ◽

Lipid Peroxidation ◽

Arterial Hypertension ◽

Antihypertensive Therapy ◽

Enzyme Inhibitor ◽

Combined Therapy ◽

Density Lipoprotein ◽

Aggregation Activity ◽

Long Acting ◽

The Impact

The impact of antihypertensive therapy with the angiotensin-converting enzyme inhibitor enalapril (enap) and with enalapril in combination with the long-acting calcium channel blocker verapamil SR (isoptin SR) on changes of plasmatic, vascular-thrombocytic hemostasis and lipid peroxidation in patients with metabolic syndrome and arterial hypertension was studied. Combined therapy with enalapril and verapamil significantly reduces the fasting glucose and glycated hemoglobin concentrations, the aggregation activity of thrombocytes in the patient's blood, inhibits the lipid peroxidation, increases the level of high-density lipoprotein cholesterol, and decreases the coefficient of atherogenecity. Combined therapy with enalapril and verapamil SR can be recommended for treatment of arterial hypertension in patients with metabolic syndrome.

Download Full-text

Effects on cognitive function, psychoemotional state, efficiacy and safety of antihypertensive therapy by metoprolol retard in females with the mild to moderate hypertension

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2006-12-4-358-361 ◽

2006 ◽

Vol 12 (4) ◽

pp. 358-361

Author(s):

T. S. Poljatykina ◽

I. E. Mishina ◽

G. I. Bulychev ◽

V. L. Geller ◽

G. I. Sevastjanova ◽

...

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Cognitive Function ◽

Arterial Hypertension ◽

Antihypertensive Therapy ◽

Moderate Hypertension ◽

Combined Therapy ◽

Psychoemotional State ◽

Long Acting

The paper presents the results of research in which 50 women with essential hypertension illness (arterial hypertension I-II degree) have taken part. 20 patients received long-acting metoprolol therapy (Egilok - retard, EGIS AO) in the dose of 25-100 mg, if necessary in a combination with hydrochlorothiazide 25 mg. In group of comparison (30 subjects) treatment with enalapril (5-10 mg/сут) or by a combination of enalapril and hydrochlorothiazide was administarted. It is shown, that monotherapy by metoprolol-retard allowed to reach a «target» levels of blood pressure in 89,5 % of women, in 10,5 % cases the combined therapy was required. At 12-week of treatment significant improvement of parameters of concentration of attention and anxiety decrease was observed.

Download Full-text

Combined treatment for acromegaly with long-acting somatostatin analogs and pegvisomant: long-term safety for up to 4.5 years (median 2.2 years) of follow-up in 86 patients

Acta Endocrinologica ◽

10.1530/eje-08-0843 ◽

2009 ◽

Vol 160 (4) ◽

pp. 529-533 ◽

Cited By ~ 81

Author(s):

SJCMM Neggers ◽

WW de Herder ◽

JAMJL Janssen ◽

RA Feelders ◽

AJ van der Lely

Keyword(s):

Combined Therapy ◽

Combined Treatment ◽

Somatostatin Analogs ◽

Pituitary Surgery ◽

Median Dosage ◽

Previously Treated ◽

Long Acting

BackgroundWe previously reported on the efficacy, safety, and quality of life (QoL) of long-acting somatostatin analogs (SSA) and (twice) weekly pegvisomant (PEG-V) in acromegaly and improvement after the addition of PEG-V to long-acting SSA.ObjectiveTo assess the long-term safety in a larger group of acromegalic patients over a larger period of time: 29.2 (1.2–57.4) months (mean (range)).DesignPegvisomant was added to SSA monotherapy in 86 subjects (37 females), to normalize serum IGF1 concentrations (n=63) or to increase the QoL. The median dosage was 60.0 (20–200) mg weekly.ResultsAfter a mean treatment period of 29.2 months, 23 patients showed dose-independent PEG-V related transient liver enzyme elevations (TLEE). TLEE occurred only once during the continuation of combination therapy, but discontinuation and re-challenge induced a second episode of TLEE. Ten of these patients with TLEE also suffered from diabetes mellitus (DM). In our present series, DM had a 2.28 odds ratio (CI 1.16–9.22; p=0.03) higher risk for developing TLEE. During the combined therapy, a clinical significant decrease in tumor size by more than 20% was observed in 14 patients. Two of these patients were previously treated by pituitary surgery, 1 with additional radiotherapy and all other patients received primary medical treatment.ConclusionLong-term combined treatment with SSA and twice weekly PEG-V up to more than 4 years seems to be safe. Patients with both acromegaly and DM have a 2.28 higher risk of developing TLEE. Clinical significant tumor shrinkage was observed in 14 patients during combined treatment.

Download Full-text

Triple therapy in uncontrolled asthma: a network meta-analysis of Phase III studies

European Respiratory Journal ◽

10.1183/13993003.04233-2020 ◽

2021 ◽

pp. 2004233

Author(s):

Paola Rogliani ◽

Beatrice Ludovica Ritondo ◽

Luigino Calzetta

Keyword(s):

Meta Analysis ◽

Phase Iii ◽

Fixed Dose ◽

High Dose ◽

Severe Exacerbation ◽

Triple Combination ◽

Combination Therapies ◽

Uncontrolled Asthma ◽

Long Acting ◽

The Impact

Conflicting evidence is currently available concerning the impact on asthma exacerbation of triple inhaled corticosteroid (ICS), long-acting β2-adrenoceptor agonist (LABA), and long-acting muscarinic receptor antagonist (LAMA) fixed-dose combination (FDC). Since meta-analyses allow settling controversies of apparently inconsistent results, we performed a network meta-analysis of Phase III randomised controlled trials including 9535 patients to assess the effect of ICS/LABA/LAMA combinations in uncontrolled asthma. Triple combination therapies with an ICS administered at high dose (HD) were more effective (p<0.05) than medium dose (MD) ICS/LABA/LAMA FDC and both MD and HD ICS/LABA FDCs against moderate to severe exacerbation (relative risk [RR] from 0.61 to 0.80) and increasing trough forced expiratory volume in the 1st second (mL from +33 to +114). Triple combination therapies including HD ICS were superior (p<0.05) than MD ICS/LABA/LAMA FDC in preventing severe exacerbation (RR from 0.46 to 0.65), but not with respect to moderate exacerbation (p>0.05). Triple combination therapies were equally effective on asthma control, with no safety concerns. This quantitative synthesis suggests that ICS/LABA/LAMA FDCs are effective and safe in uncontrolled asthma, and that the dose of ICS in the combination represents the discriminating factor to treat patients with a history of moderate or severe exacerbation.

Download Full-text