scholarly journals Features of asthma treatment during pregnancy

2019 ◽  
Vol 16 (2) ◽  
pp. 14-19
Author(s):  
O V Lavrova ◽  
M A Petrova ◽  
G B \\Fedoseev
Keyword(s):  
Pregnant Women ◽  
Bronchial Asthma ◽  
Pregnancy Complications ◽  
Inhaled Corticosteroids ◽  
Combined Therapy ◽  
Persistent Asthma ◽  
Asthma Therapy ◽  
Asthma Treatment ◽  
Complete Control ◽  
Standard Procedures

Study goal. To analyse asthma therapy in pregnant women with bronchial asthma at a period since 2002 to 2017. Materials and methods. 3890 pregnant women with asthma were examined and followed up during pregnancy at a period since 2002 to 2017. Comprehensive clinicalfunctional examination was conducted. Patients were under surveillance of the obstetriciangynecologist during the whole pregnancy, standard procedures were carried out, and the frequency of complications of pregnancy was estimated. Basic therapy of asthma was compared in groups with the persistent asthma duration, followed up since 2002 to 2009 (1 group) and since 2010 to 2017 (2 group). Also, frequency of pregnancy complications was estimated in these groups. Results. The second group (2010-2017) demonstrated reliably lower frequency of threatening abortion, hypertension and preeclampsia. At the same time the frequency of inhaled corticosteroids (ICS) administration as a part of the combined therapy increased from 21.79% to 63.87% (almost to three times) in comparison with the first group (2002-2009). Conclusions. Combined therapy with ICS/LABA provides most complete control of bronchial asthma, and decreases frequency of pregnancy complications in pregnant women with BA.

ОСОБЕННОСТИ ЛЕЧЕНИЯ БРОНХИАЛЬНОЙ АСТМЫ В ПЕРИОД БЕРЕМЕННОСТИ

2019 ◽  
Author(s):  
O.V. Lavrova ◽  
M.A. Petrova ◽  
G.B. Fedoseev
Keyword(s):  
Pregnant Women ◽  
Bronchial Asthma ◽  
Pregnancy Complications ◽  
Inhaled Corticosteroids ◽  
Combined Therapy ◽  
Persistent Asthma ◽  
Asthma Therapy ◽  
Complete Control ◽  
Basic Therapy ◽  
Standard Procedures

Цель. Анализ характера терапии бронхиальной астмы, а также течения беременности у пациенток с бронхиальной астмой в период с 2002 по 2017 г. Материалы и методы. С 2002 по 2017 г. обследованы и проходили наблюдение в период беременности 3890 пациенток, страдающих бронхиальной астмой. Проводилось комплексное клинико-функциональное обследование. Пациентки находились под наблюдением акушера-гинеколога весь срок беременности, проходили стандартное обследование, оценивалась частота осложнений беременности. Было проведено сравнение характера базисной терапии бронхиальной астмы в группах пациенток с персистирующим течением заболевания, наблюдавшихся с 2002 по 2009 г. (1-я группа) и с 2010 по 2017 г. (2-я группа) в сопоставлении с частотой встречаемости осложнений беременности в данных группах. Результаты. При сравнении частоты встречаемости угрозы прерывания беременности, гипертензивных расстройств, преэклампсии выявлена достоверно более низкая частота встречаемости этих осложнений беременности во 2-й группе (2010-2017 гг.). При этом частота назначения ингаляционных глюкокортикостероидов (ИГКС) в составе комбинированных препаратов возросла с 21,79 до 63,87, что практически в три раза превышает данный показатель в 1-й группе (2002-2009 гг.). Заключение. При сопоставлении изменений в характере базисной терапии, произошедших с 2002 по 2017 г., с достоверным снижением частоты встречаемости осложнений беременности в группе, наблюдавшейся с 2010 по 2017 г., можно предположить, что именно терапия комбинированными препаратами ИГКС/ агонистов Р2-адренорецпторов длительного действия позволяет наиболее полноценно обеспечивать контроль бронхиальной астмы, приводя к снижению частоты осложнений беременностиStudy goal. To analyse asthma therapy in pregnant women with bronchial asthma at a period since 2002 to 2017. Materials and methods. 3890 pregnant women with asthma were examined and followed up during pregnancy at a period since 2002 to 2017. Comprehensive clinicalfunctional examination was conducted. Patients were under surveillance of the obstetriciangynecologist during the whole pregnancy, standard procedures were carried out, and the frequency of complications of pregnancy was estimated. Basic therapy of asthma was compared in groups with the persistent asthma duration, followed up since 2002 to 2009 (1 group) and since 2010 to 2017 (2 group). Also, frequency of pregnancy complications was estimated in these groups. Results. The second group (2010-2017) demonstrated reliably lower frequency of threatening abortion, hypertension and preeclampsia. At the same time the frequency of inhaled corticosteroids (ICS) administration as a part of the combined therapy increased from 21.79 to 63.87 (almost to three times) in comparison with the first group (2002-2009). Conclusions. Combined therapy with ICS/LABA provides most complete control of bronchial asthma, and decreases frequency of pregnancy complications in pregnant women with BA.

ОСОБЕННОСТИ ЛЕЧЕНИЯ БРОНХИАЛЬНОЙ АСТМЫ В ПЕРИОД БЕРЕМЕННОСТИ

2019 ◽  
pp. 14-19
Author(s):  
O.V. Lavrova ◽  
M.A. Petrova ◽  
G.B. Fedoseev
Keyword(s):  
Pregnant Women ◽  
Bronchial Asthma ◽  
Pregnancy Complications ◽  
Inhaled Corticosteroids ◽  
Combined Therapy ◽  
Persistent Asthma ◽  
Asthma Therapy ◽  
Complete Control ◽  
Basic Therapy ◽  
Standard Procedures

Цель. Анализ характера терапии бронхиальной астмы, а также течения беременности у пациенток с бронхиальной астмой в период с 2002 по 2017 г. Материалы и методы. С 2002 по 2017 г. обследованы и проходили наблюдение в период беременности 3890 пациенток, страдающих бронхиальной астмой. Проводилось комплексное клиникофункциональное обследование. Пациентки находились под наблюдением акушерагинеколога весь срок беременности, проходили стандартное обследование, оценивалась частота осложнений беременности. Было проведено сравнение характера базисной терапии бронхиальной астмы в группах пациенток с персистирующим течением заболевания, наблюдавшихся с 2002 по 2009 г. (1я группа) и с 2010 по 2017 г. (2я группа) в сопоставлении с частотой встречаемости осложнений беременности в данных группах. Результаты. При сравнении частоты встречаемости угрозы прерывания беременности, гипертензивных расстройств, преэклампсии выявлена достоверно более низкая частота встречаемости этих осложнений беременности во 2й группе (20102017 гг.). При этом частота назначения ингаляционных глюкокортикостероидов (ИГКС) в составе комбинированных препаратов возросла с 21,79 до 63,87, что практически в три раза превышает данный показатель в 1й группе (20022009 гг.). Заключение. При сопоставлении изменений в характере базисной терапии, произошедших с 2002 по 2017 г., с достоверным снижением частоты встречаемости осложнений беременности в группе, наблюдавшейся с 2010 по 2017 г., можно предположить, что именно терапия комбинированными препаратами ИГКС/ агонистов Р2адренорецпторов длительного действия позволяет наиболее полноценно обеспечивать контроль бронхиальной астмы, приводя к снижению частоты осложнений беременностиStudy goal. To analyse asthma therapy in pregnant women with bronchial asthma at a period since 2002 to 2017. Materials and methods. 3890 pregnant women with asthma were examined and followed up during pregnancy at a period since 2002 to 2017. Comprehensive clinicalfunctional examination was conducted. Patients were under surveillance of the obstetriciangynecologist during the whole pregnancy, standard procedures were carried out, and the frequency of complications of pregnancy was estimated. Basic therapy of asthma was compared in groups with the persistent asthma duration, followed up since 2002 to 2009 (1 group) and since 2010 to 2017 (2 group). Also, frequency of pregnancy complications was estimated in these groups. Results. The second group (20102017) demonstrated reliably lower frequency of threatening abortion, hypertension and preeclampsia. At the same time the frequency of inhaled corticosteroids (ICS) administration as a part of the combined therapy increased from 21.79 to 63.87 (almost to three times) in comparison with the first group (20022009). Conclusions. Combined therapy with ICS/LABA provides most complete control of bronchial asthma, and decreases frequency of pregnancy complications in pregnant women with BA.

CLINICAL AND SPIROGRAPHIC FEATURES OF BRONCHIAL ASTHMA IN SCHOOLCHILDREN DEPENDING ON THE DIFFERENT REGIMENS OF BASIC ANTI-INFLAMMATORY THERAPY

2020 ◽  
Vol 73 (1) ◽  
Author(s):  
Olena Koloskova ◽  
Tetiana Bilous ◽  
Galyna Bilyk ◽  
Kristina Buryniuk-Glovyak ◽  
Olena Korotun ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Persistent Asthma ◽  
High Specificity ◽  
Clinical Feature ◽  
Clinical Group ◽  
Comparison Groups ◽  
Anti Inflammatory ◽  
High Doses ◽  
Persistent Bronchial Asthma

The aim: To study the clinical and spirographic features persistence of the bronchial asthma in schoolchildren against the background of the alternative daily doses of inhaled corticosteroids to increase the effectiveness of anti-inflammatory therapy for this disease. Materials and methods: A complete comprehensive clinical-paraclinical examination of 65 schoolchildren with persistent asthma was conducted. According to the average daily dose of inhaled corticosteroids (ICS) the patients were divided into two clinical groups. The first (I) group consisted of 46 children who received ICS in the regimen of low-to-medium equipotent doses (253.95±9.98 μg per day), and the second (II) comparison group was formed of 19 patients who controlled the pBA using high doses of ICS (494.74±5.56 μg per day). Results: The patients of the І clinical group compared to patients of the ІІ group have a higher risk of the mild bronchial obstructive syndrome during asthma attacks. In assessing the level of control of persistent bronchial asthma using the CIA-scale, it was found that in II group cases of the controlled course of the disease were observed almost two times less than in children of the I group of comparison. In conducting spirography in children of comparison groups, it was shown that the ratio of indices of bronchospasm (FEV1/ FVC) was worse in patients receiving high doses of ICS. Conclusions: So, сharacteristic clinical feature of asthma controlled by high doses of ICS is more severe nature of bronchial obstructive syndrome during the period of exacerbation (OR=1.9-3.0). In the management of persistent bronchial asthma, the Gensler index which has high specificity (94.4%) and accuracy (92.2%) should be used for disease control verification.

scholarly journals Serum Eosinophilic cationic protein (ECP) as an effective biological marker to monitor therapy in bronchial asthma patients.

2011 ◽  
Vol 5 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Afroza Begum ◽  
Humayun Sattar ◽  
Abu Naser Ibne Sattar ◽  
Md. Ruhul Amin Miah ◽  
Ahmed Abu Saleh
Keyword(s):  
Bronchial Asthma ◽  
Persistent Asthma ◽  
Biological Marker ◽  
Forced Expiratory Volume ◽  
Asthma Therapy ◽  
Eosinophilic Cationic Protein ◽  
Cationic Protein ◽  
Before And After ◽  
Asthma Patients

Clinically diagnosed bronchial asthma patients comprising of new cases, on therapy or follow up were enrolled for this study to see if the new biological marker Eosinophilic cationic protein (ECP) can be used as a more precise marker to monitor therapy than the presently used conventional ones like FEV1% predicted, PEFR, and Circulating eosinophil (C.E) count. Out of 70 bronchial asthma patients, 30 intermittent, 4 mild persistent, 24 moderate persistent and 12 severe persistent asthma patients were included, while 45 cases were enrolled for follow up. Serum level of eosinophil granular protein, Eosinophilic cationic protein (ECP) was measured in relation to changes in their forced expiratory volume in 1st second (FEV1% predicted) and Circulating Eosinophil count (%) before and after therapy in 45 follow up patients on asthma therapy. In this study, it was observed that C.E count (%) and FEV1% predicted were not decreased significantly and serum eosinophilic cationic protein (ECP) decreased significantly (p<0.001) after asthma therapy. Thus, serum ECP level can be used as a biological marker than other conventionally used marker (FEV1, C.E count) to monitor therapeutic efficacy in bronchial asthma patients.DOI: http://dx.doi.org/10.3329/bjmm.v5i1.15813 Bangladesh J Med Microbiol 2011; 05 (01): 3-7

scholarly journals Mechanisms of formation of airway hyperreactivity in view of phenotypical heterogeneity and clinical deviation of bronchial asthma in adolescents (literature review)

2021 ◽  
pp. 47-54
Author(s):  
О.К. Koloskova ◽  
◽  
О.О. Shakhova ◽  
S.І. Tarnavska ◽  
O.V. Vlasova ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Persistent Asthma ◽  
High Body Mass Index ◽  
Airway Hyperreactivity ◽  
Extremely Low Birth Weight ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Bronchial Inflammation ◽  
Mechanisms Of Formation

Bronchial asthma is a disease characterized by recurrent episodes of variable bronchial obstruction, chronic bronchial inflammation, bronchial hypersensitivity and remodulation. Modern therapy of the disease was aimed at these links of pathogenesis, and this concept postulated the need for long-term use of anti-inflammatory drugs and, above all, topical inhaled corticosteroids. However, it should be recognized that the coherent inflammatory theory currently requires revision and new understanding, or even replacement with a new theory, which, considering these characteristics of the disease as an epiphenomenon, will serve as a basis for new approaches in treatment and prevention. The aim of our work — to analyze the mechanisms of formation of bronchial hyperreactivity, taking into account the phenotypic heterogeneity and clinical deviation of bronchial asthma in adolescence (based on the analysis of scientific sources). It is extremely important to determine the risk of transition of the adolescents' bronchial asthma into adulthood, when chronic obstructive pulmonary diseases might develop. Among the main predictors of this risk such factors as age, obesity, early puberty, body weight at birth and in the newborn period and sex can be distin guished. Thus, some authors associate the risk of persistence of the disease with its onset in early childhood, and others — at the age of 6 years old. High body mass index and early onset of puberty are considered to be the predictors of persistent bronchial asthma. It is noted that low and extremely low birth weight of premature infants or rapid weight gain in the neonatal period are associated with a decrease in lung ventilation and the risk of persistent asthma in the future. It is believed that bronchial asthma in children is more common in boys than in girls, in contrast, during puberty, allergic diseases and asthma are more common in girls. Conclusions. The above mentioned literature data give reason to believe that, despite advances in the scientific understanding of the pathogenesis of the main characteristics of bronchial asthma, there are great difficulties in using them in practice. Moreover, current inflammatory paradigm of bronchial asthma needs to be revised because it being a dogma becomes unproductive from a clinical point of view. No conflict of interest was declared by the authors. Key words: asthma, adolescents, hyperreactivity, remission.

scholarly journals 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

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.

scholarly journals Prescription pattern among patients having mild to moderate bronchial asthma using metered dose inhaler and dry powder inhaler in tertiary hospital in western india

2018 ◽  
Vol 7 (4) ◽  
pp. 792
Author(s):  
Neha Akhoon ◽  
D. B. S. Brashier
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Airflow Obstruction ◽  
Tertiary Hospital ◽  
Inhalation Technique ◽  
Western India ◽  
Complete Control ◽  
Leukotriene Antagonists ◽  
Prescription Pattern ◽  
Β2 Agonists

Background: Bronchial asthma is a syndrome characterized by airflow obstruction that manifests as shortness of breath, wheezing and cough. The treatment is tailored according to the severity of the disease. The drugs used for treatment of bronchial asthma include inhaled corticosteroids, beta-2 agonists, methylxanthines, leukotriene antagonists and mast cell stabilizers. Despite the availability of all these drugs, which are recommended for the treatment, not every patient achieves complete control of the disease. The reason behind this could be irrational prescribing of drugs for the treatment and errors in the technique of using inhaler devices. Though rational prescribing of drugs and correct technique for the use of inhaler can be improved by proper training of target population, but there is paucity of such data in our country.Methods: This study was planned to monitor prescription pattern and errors in use of inhalation devices, in patients diagnosed as cases of mild to moderate bronchial asthma, attending Out Patient Department (OPD) of respiratory medicine of a tertiary hospital. A total of 207 patients were recruited and their prescription pattern and inhalation technique were assessed.Results: The study showed that inhaled short acting β2-agonists and inhaled corticosteroids were the most commonly used drug groups, which were prescribed to all the patients in the study, followed by long acting β2-agonists, leukotriene antagonists and methylxanthines in decreasing order.Conclusions: As a conclusion, the treating physicians were prescribing according to the laid down guidelines. It is concluded that such studies should be periodically done to ensure the adherence to the treatment guidelines.

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 Rational therapy of asthma in children with inhaled corticosteroids

2016 ◽  
Vol 1 (1) ◽  
pp. 63-67
Author(s):  
N. A. Geppe ◽  
N. G. Kolosova ◽  
S. I. Shatalina
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Persistent Asthma ◽  
Initial Therapy ◽  
Rational Therapy ◽  
Asthma In Children ◽  
Effective Drugs

Currently, the most effective drugs for the treatment and management of bronchial asthma (BA) are inhaled corticosteroids (ICS) which, according to global guidelines, are indicated as initial therapy for persistent asthma of any severity.

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