Rewolucyjne zmiany w raporcie GINA 2019 – jeden inhalator w terapii podtrzymującej i ratunkowej dla większości chorych na astmę
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Abstrakt
Raport GINA 2019 wprowadza rewolucyjne zmiany w farmakoterapii astmy u dzieci w wieku > 5 lat, młodzieży i dorosłych. Ze względów bezpieczeństwa eksperci raportu GINA 2019 nie zalecają już stosowania krótko działających b2-mimetyków (SABA) w monoterapii, lecz zawsze w połączeniu z glikokortykosteroidem wziewnym (GKSw). U wszystkich dorosłych oraz dzieci w wieku ≥ 12 lat preferowanym leczeniem kontrolującym są GKSw w dawce zależnej od objawów astmy lub glikokortykosteroidy wziewne z formoterolem w schemacie SMART/MART (terapia podtrzymująca i ratunkowa z tego samego inhalatora). Alternatywa to glikokortykosteroidy wziewne z długo działającym b2-mimetykiem w dawkowaniu „sztywnym” oraz SABA „na żądanie”. Optymalnym sposobem leczenia dla zdecydowanej większości chorych na astmę w wieku ≥ 12 lat jest obecnie terapia SMART/MART, najskuteczniej zapobiegająca zaostrzeniom choroby. Może być ona realizowana za pomocą budezonidu z formoterolem z inhalatorów suchego proszku (Easyhaler®, Turbuhaler® i Spiromax®) lub beklometazonu z formoterolem z inhalatora ciśnieniowego dozującego.
Pobrania
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