Glikokortykosteroidy wziewne w astmie – jakie, komu, kiedy, jak?
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wrz 30, 2011
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glikokortykosteroidy wziewne, budezonid, astma, inhalatory suchego proszku
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Abstrakt
W pracy przedstawiono podstawowe dane rejestracyjne glikokortykosteroidów wziewnych (GKSw) obecnych na rynku w Polsce. Omówiono metody inhalacji GKSw, kładąc szczególny nacisk na inhalatory suchego proszku i nebulizację oraz opisano obieg GKSw w ustroju i czynniki warunkujące wielkość depozycji płucnej tych leków. Efektywność kliniczna GKSw w astmie zależy od wielkości depozycji płucnej, struktury aerozolu, w tym frakcji cząstek drobnych, oraz właściwości danego leku. W oparciu o analizę aktualnych konsensusów i przewodników pokazano miejsce i zalecane dawki różnych GKSw w terapii astmy, zarówno u dzieci, jak i u dorosłych.
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Emeryk , A., Bartkowiak-Emeryk , M., & Emeryk-Maksymiuk , J. (2011). Glikokortykosteroidy wziewne w astmie – jakie, komu, kiedy, jak?. Alergoprofil, 7(3), 2-9. Pobrano z https://journalsmededu.pl/index.php/alergoprofil/article/view/276
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Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
Bibliografia
1. Busse W.W., Lemanske R.F.: Asthma. N. Engl. J. Med. 2001, 344: 350-362.
2. Haldar P., Pavord I.D., Shaw D.E. et al.: Cluster analysis and clinical asthma phenotypes. Am. J. Respir. Crit. Care Med. 2008, 178: 218-224.
3. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, NHLBI/WHO Workshop Report. NHI. NHBLI Publication No 02-3569, 2002.
4. Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) Update 2008.
5. Global Strategy for the Diagnosis and Treatment of Asthma in Children 5 Years and Younger 2009.
6. Bacharier L.B., Boner A., Carlsen K.-H. et al.: Diagnosis and treatment of asthma in childhood: a PRACTALL consensus report. Allergy 2008, 63: 5-34.
7. British Guideline on the Management of Asthma, British Thoracic Society Scottish Intercollegiate Network. Thorax 2008, 63: 1-121.
8. Barnes P.J., Pedersen S., Busse W.W.: Efficacy and safety of inhaled corticosteroids: new developments. Am. J. Respir. Crit. Care Med. 1998, 157: S1-S53.
9. Barnes P.J.: Molecular mechanisms and cellular effects of glucocorticosteroids. Immunol. Allergy Clin. N. Am. 2005, 25: 451-468.
10. Kulus M.: Mechanizm działania glikokortykosteroidów wziewnych. W: Bezpieczna i racjonalna glikokortykosteroidoterapia wziewna u dzieci. Kurzawa R. (red.). Medpress, Warszawa 2005: 11-23.
11. Busse W.W., Bleecker E.R., Bateman E.D. et al.: Fluticasone furoate demonstrates efficacy in patients with asthma symptomatic on medium doses of inhaled corticosteroid therapy: an 8-week, randomised, placebo-controlled trial. Thorax 2011 Aug 9 [online].
12. Sosnowski T.: Ocena nowej formulacji proszku do inhalacji zawierającego propionian flutikazonu. Alergia 2010, 3: 13-17.
13. Zduńczyk A., Pirożyński M.: Tabelaryczny wykaz leków inhalacyjnych zarejestrowanych w Polsce. W: Astma i choroby obturacyjne oskrzeli u dzieci. Bręborowicz A., Emeryk A., Lis G. (red.). Elsevier Urban & Partner, Wrocław 2010: 331-359.
14. Roy A., Battle K., Lurslurchachai L. et al.: Inhaler device, administration technique, and adherence to inhaled corticosteroids in patients with asthma. Prim. Care Respir. J. 2011, 20: 148-154.
15. Price D., Haughney J., Sims E. et al.: Effectiveness of inhaler types for real-world asthma management: retrospective observational study using the GPRD. J. Asthma Allergy 2011, 4: 37-47.
16. Emeryk A. et al.: Glikokortykosteroidy w astmie. W: Astma i choroby obturacyjne oskrzeli u dzieci. Bręborowicz A., Emeryk A., Lis G. (red.). Elsevier Urban & Partner 2010, 121-144.
17. Banes N.C.: The properties of inhaled corticosteroids: similarities and differences. Prim. Care Respir. J. 2007, 16: 149-154.
18. Sobande P.O., Kercsmar C.M.: Inhaled corticosteroids in asthma management. Respir. Care 2008, 53: 625-633.
19. Winkler J., Hochhaus G., Derendorf H.: How the lung handles drugs: pharmacokinetics and pharmacodynamics of inhaled corticosteroids. Proc. Am. Thorac. Soc. 2004, 1: 356-363.
20. Derendorf H., Pedersen S.: Choosing an inhaled corticosteroid for once-daily administration in asthma. Respir. Dig. 2004, 6: 1-11.
21. Tunek A., Sjodin K., Hallstrom G.: Reversible formation of fatty acid esters of budesonide, an antiasthma glucocorticoid, in human lung and microsomes. Drug Metab. Dispos. 1997, 25: 1311-1317.
22. Allen D.P., Bielory L., Derendorf H. et al.: Inhaled corticosteroids: past lessons and future issues. J. Allergy Clin. Immunol. 2003, 112 (suppl. 3): S1-S40.
23. Thorsson L., Edsbacker S., Conradson T.B.: Lung deposition of budesonide from Turbuhaler is twice that from a pressurized metered-does inhaler p-MDI. Eur. Respir. J. 1994, 7: 1839-1844.
24. Pitcairn G., Leader S., Pavia D. et al.: Deposition if corticosteroid aerosol in the human lung by Respimat Soft Mist inhaler compared to deposition by metered dose inhaler or by Turbuhaler dry powder inhaler. J. Aerosol. Med. 2005, 18: 264-272.
25. Leach C.L., Davidson P.J., Hasselquist B.E. et al.: Lung deposition of hydrofluoroalkane-134a beclomethasone is greater than that of chlorofluorocarbon fluticasone and chlorofluorocarbon beclomethasone: a cross-over study in healthy volunteers. Chest 2002, 122: 510-516.
26. Newman S., Salmon A., Nave R. et al.: High lung deposition of 99mTc-labeled ciclesonide administered via HFA-MDI to patient with asthma. Respir. Med. 2006, 100: 375-384.
27. Pickering H., Pitcairn G.R., Hirst P.H. et al.: Regional lung deposition of a technetium 99m-labeled formulation of mometasone furoate administered by hydrofluoroalkane 227 metered-dose inhaler. Clin. Ther. 2000, 22: 1483-1493.
28. De Backer W., Devolder A., Poli G. et al.: Lung deposition of BDP/formoterol HFA pMDI in healthy volunteers, asthmatic and COPD patients. J. Aerosol. Med. Pulm. Drug Deliv. 2010, 23: 137-148.
29. Dolovich M.B.: Aerosol delivery devices and airway/lung deposition. W: Inhaled steroids in asthma – optimizing effects in the airways. Schleimer R.P. (red.). Marcel Decker Inc., New York, Basel 2002: 169-212.
30. Dolovich M.B., Dhand R.: Aerosol drug delivery: developments in device design and clinical use. Lancet 2011, 377 (9770): 1032-1045.
31. Munzel U., Marschall K., Fyrnys B. et al.: Variability of fine particle dose and lung deposition of budesonide delivered through two multidose dry powder inhalers. Curr. Med. Res. Opin. 2005, 21: 827-833.
32. Newman S., Pitcairn G., Hirst P. et al.: Scintigraphic comparison of budesonide deposition from two dry powder inhalers. Eur. Respir. J. 2000, 16: 178-183.
33. Agertoft L., Pedersen S.: Lung deposition and systemic availability of fluticasone Diskus and budesonide Turbuhaler in children. Am. J. Respire Crit. Care Med. 2003, 168: 779-782.
34. Hirst R.H., Newman S.R., Clark D.A. et al.: Lung deposition of budesonide from the novel dry powder inhaler Airmax. Respir. Med. 2002, 96: 389-396.
35. Derendorf H., Nave R., Drollmann A. et al.: Relevance of pharmacokinetics and pharmacodynamics of inhaled corticosteroids to asthma. Eur. Respir. J. 2006, 28: 1042-1050.
36. Mullinger B.: Drug output of inhalers is not a predictor of lung dose. Inhaled Drug Delivery Conference. 12–13 Nov. 2008, Sofitel, London.
37. De Backer W., Devolder A., Poli G. et al.: Lung deposition of BDP/formoterol HFA pMDI in healthy volunteers, asthmatic and COPD patients. J. Aerosol. Med. Pulm. Drug Deliv. 2010, 23: 137-148.
38. Broeders M.E., Molema J., Burnell P.K. et al.: Ventolin Diskus and Inspyril Turbuhaler: an in vitro comparison. J. Aerosol Med. 2005, 18: 74-82.
39. Virchow J.Ch.: What plays a role in the choice of inhaler device for asthma therapy? Curr. Med. Res. Opin. 2005, 21 (suppl. 4): S19-S26.
40. Czerwińska-Pawluk I.: Czynniki determinujące wybór inhalatora suchego proszku u dzieci chorych na astmę oskrzelową. Praca doktorska. Akademia Medyczna w Lublinie, 2005.
41. Hirst P.H., Bacon R.E., Pitcairn G.R. et al.: A comparison of the lung deposition of budesonide from Easyhaler, Turbuhaler and pMDI plus spacer in asthmatic patients. Respir. Med. 2001, 9: 720-727.
42. Palander A., Mattila T., Karka M. et al.: In vitro comparison of three salbutamol-containing multidose dry powder inhalers. Clin. Drug. Invest. 2000, 20: 25-33.
43. Thorsson L., Edsbacker S., Kallen A. et al.: Pharmacokinetics and systemic activity of fluticasone via Diskus and pMDI, and of budesonide via Turbuhaler. Br. J. Clin. Pharmacol. 2001, 52: 529-538.
44. Barnes P., Virchow J., Sanchis J. et al.: Asthma management: important issues. Eur. Respir. Rev. 2005, 14: 147-151.
45. Lass J.S., Sant A., Knoch M.: New advances in aerosolised drug delivery: vibrating membrane nebuliser technology. Expert Opinion on Drug Delivery 2006, 5: 693-702.
46. Rubin B.K.: Nebulizer therapy for children: the device-patient interface. Respir. Care 2002, 47: 1314-1319.
47. Nikander K., Agertoft L., Pedersen S. et al.: Breath-synchronized nebulization diminishes the impact of patient-device interfaces (face mask or mouthpiece) on the inhaled mass of nebulized budesonide. J. Asthma 2000, 37: 451-459.
48. Nikander K., Turpeinen M., Wollmer P. et al.: Evaluation of pulsed and breath-synchronized nebulization of budesonide as a means of reducing nebulizer wastage of drug. Ped. Pulmonol. 2000, 29: 120-126.
49. Rubin B.K.: Air and soul: the science and application of aerosol therapy. Respir. Care 2010, 55: 911-921.
50. Powell H., Gibson P.: Inhaled corticosteroid doses is asthma: an evidence based approach. Med. J. Austr. 2003, 178: 223-228.
51. Global Initiative for Asthma Prevention and Treatment. GINA 2010.
52. Agertoft L., Pedersen S.: Effects of long-term treatment with an inhaled corticosteroid on growth and pulmonary function in asthmatic children. Respir. Med. 1994, 88: 373-381.
53. Knuffman J.E., Sorkness C.A., Lemanske R.F. Jr et al.: Phenotypic predictors of long-term response to inhaled corticosteroid and leukotriene modifier therapies in pediatric asthma. J. Allergy Clin. Immunol. 2009, 123: 411-416.
54. Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma. Summary Report 2007. J. Allergy Clin. Immunol. 2007, 120 (5 suppl.): S94-S138.
55. Volovitz B., Bilavsky E., Nussinovitch M.: Effectiveness of high repeated doses of inhaled budesonide or fluticasone in controlling acute asthma exacerbations in young children. J. Asthma 2008, 45: 561-567.
2. Haldar P., Pavord I.D., Shaw D.E. et al.: Cluster analysis and clinical asthma phenotypes. Am. J. Respir. Crit. Care Med. 2008, 178: 218-224.
3. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, NHLBI/WHO Workshop Report. NHI. NHBLI Publication No 02-3569, 2002.
4. Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) Update 2008.
5. Global Strategy for the Diagnosis and Treatment of Asthma in Children 5 Years and Younger 2009.
6. Bacharier L.B., Boner A., Carlsen K.-H. et al.: Diagnosis and treatment of asthma in childhood: a PRACTALL consensus report. Allergy 2008, 63: 5-34.
7. British Guideline on the Management of Asthma, British Thoracic Society Scottish Intercollegiate Network. Thorax 2008, 63: 1-121.
8. Barnes P.J., Pedersen S., Busse W.W.: Efficacy and safety of inhaled corticosteroids: new developments. Am. J. Respir. Crit. Care Med. 1998, 157: S1-S53.
9. Barnes P.J.: Molecular mechanisms and cellular effects of glucocorticosteroids. Immunol. Allergy Clin. N. Am. 2005, 25: 451-468.
10. Kulus M.: Mechanizm działania glikokortykosteroidów wziewnych. W: Bezpieczna i racjonalna glikokortykosteroidoterapia wziewna u dzieci. Kurzawa R. (red.). Medpress, Warszawa 2005: 11-23.
11. Busse W.W., Bleecker E.R., Bateman E.D. et al.: Fluticasone furoate demonstrates efficacy in patients with asthma symptomatic on medium doses of inhaled corticosteroid therapy: an 8-week, randomised, placebo-controlled trial. Thorax 2011 Aug 9 [online].
12. Sosnowski T.: Ocena nowej formulacji proszku do inhalacji zawierającego propionian flutikazonu. Alergia 2010, 3: 13-17.
13. Zduńczyk A., Pirożyński M.: Tabelaryczny wykaz leków inhalacyjnych zarejestrowanych w Polsce. W: Astma i choroby obturacyjne oskrzeli u dzieci. Bręborowicz A., Emeryk A., Lis G. (red.). Elsevier Urban & Partner, Wrocław 2010: 331-359.
14. Roy A., Battle K., Lurslurchachai L. et al.: Inhaler device, administration technique, and adherence to inhaled corticosteroids in patients with asthma. Prim. Care Respir. J. 2011, 20: 148-154.
15. Price D., Haughney J., Sims E. et al.: Effectiveness of inhaler types for real-world asthma management: retrospective observational study using the GPRD. J. Asthma Allergy 2011, 4: 37-47.
16. Emeryk A. et al.: Glikokortykosteroidy w astmie. W: Astma i choroby obturacyjne oskrzeli u dzieci. Bręborowicz A., Emeryk A., Lis G. (red.). Elsevier Urban & Partner 2010, 121-144.
17. Banes N.C.: The properties of inhaled corticosteroids: similarities and differences. Prim. Care Respir. J. 2007, 16: 149-154.
18. Sobande P.O., Kercsmar C.M.: Inhaled corticosteroids in asthma management. Respir. Care 2008, 53: 625-633.
19. Winkler J., Hochhaus G., Derendorf H.: How the lung handles drugs: pharmacokinetics and pharmacodynamics of inhaled corticosteroids. Proc. Am. Thorac. Soc. 2004, 1: 356-363.
20. Derendorf H., Pedersen S.: Choosing an inhaled corticosteroid for once-daily administration in asthma. Respir. Dig. 2004, 6: 1-11.
21. Tunek A., Sjodin K., Hallstrom G.: Reversible formation of fatty acid esters of budesonide, an antiasthma glucocorticoid, in human lung and microsomes. Drug Metab. Dispos. 1997, 25: 1311-1317.
22. Allen D.P., Bielory L., Derendorf H. et al.: Inhaled corticosteroids: past lessons and future issues. J. Allergy Clin. Immunol. 2003, 112 (suppl. 3): S1-S40.
23. Thorsson L., Edsbacker S., Conradson T.B.: Lung deposition of budesonide from Turbuhaler is twice that from a pressurized metered-does inhaler p-MDI. Eur. Respir. J. 1994, 7: 1839-1844.
24. Pitcairn G., Leader S., Pavia D. et al.: Deposition if corticosteroid aerosol in the human lung by Respimat Soft Mist inhaler compared to deposition by metered dose inhaler or by Turbuhaler dry powder inhaler. J. Aerosol. Med. 2005, 18: 264-272.
25. Leach C.L., Davidson P.J., Hasselquist B.E. et al.: Lung deposition of hydrofluoroalkane-134a beclomethasone is greater than that of chlorofluorocarbon fluticasone and chlorofluorocarbon beclomethasone: a cross-over study in healthy volunteers. Chest 2002, 122: 510-516.
26. Newman S., Salmon A., Nave R. et al.: High lung deposition of 99mTc-labeled ciclesonide administered via HFA-MDI to patient with asthma. Respir. Med. 2006, 100: 375-384.
27. Pickering H., Pitcairn G.R., Hirst P.H. et al.: Regional lung deposition of a technetium 99m-labeled formulation of mometasone furoate administered by hydrofluoroalkane 227 metered-dose inhaler. Clin. Ther. 2000, 22: 1483-1493.
28. De Backer W., Devolder A., Poli G. et al.: Lung deposition of BDP/formoterol HFA pMDI in healthy volunteers, asthmatic and COPD patients. J. Aerosol. Med. Pulm. Drug Deliv. 2010, 23: 137-148.
29. Dolovich M.B.: Aerosol delivery devices and airway/lung deposition. W: Inhaled steroids in asthma – optimizing effects in the airways. Schleimer R.P. (red.). Marcel Decker Inc., New York, Basel 2002: 169-212.
30. Dolovich M.B., Dhand R.: Aerosol drug delivery: developments in device design and clinical use. Lancet 2011, 377 (9770): 1032-1045.
31. Munzel U., Marschall K., Fyrnys B. et al.: Variability of fine particle dose and lung deposition of budesonide delivered through two multidose dry powder inhalers. Curr. Med. Res. Opin. 2005, 21: 827-833.
32. Newman S., Pitcairn G., Hirst P. et al.: Scintigraphic comparison of budesonide deposition from two dry powder inhalers. Eur. Respir. J. 2000, 16: 178-183.
33. Agertoft L., Pedersen S.: Lung deposition and systemic availability of fluticasone Diskus and budesonide Turbuhaler in children. Am. J. Respire Crit. Care Med. 2003, 168: 779-782.
34. Hirst R.H., Newman S.R., Clark D.A. et al.: Lung deposition of budesonide from the novel dry powder inhaler Airmax. Respir. Med. 2002, 96: 389-396.
35. Derendorf H., Nave R., Drollmann A. et al.: Relevance of pharmacokinetics and pharmacodynamics of inhaled corticosteroids to asthma. Eur. Respir. J. 2006, 28: 1042-1050.
36. Mullinger B.: Drug output of inhalers is not a predictor of lung dose. Inhaled Drug Delivery Conference. 12–13 Nov. 2008, Sofitel, London.
37. De Backer W., Devolder A., Poli G. et al.: Lung deposition of BDP/formoterol HFA pMDI in healthy volunteers, asthmatic and COPD patients. J. Aerosol. Med. Pulm. Drug Deliv. 2010, 23: 137-148.
38. Broeders M.E., Molema J., Burnell P.K. et al.: Ventolin Diskus and Inspyril Turbuhaler: an in vitro comparison. J. Aerosol Med. 2005, 18: 74-82.
39. Virchow J.Ch.: What plays a role in the choice of inhaler device for asthma therapy? Curr. Med. Res. Opin. 2005, 21 (suppl. 4): S19-S26.
40. Czerwińska-Pawluk I.: Czynniki determinujące wybór inhalatora suchego proszku u dzieci chorych na astmę oskrzelową. Praca doktorska. Akademia Medyczna w Lublinie, 2005.
41. Hirst P.H., Bacon R.E., Pitcairn G.R. et al.: A comparison of the lung deposition of budesonide from Easyhaler, Turbuhaler and pMDI plus spacer in asthmatic patients. Respir. Med. 2001, 9: 720-727.
42. Palander A., Mattila T., Karka M. et al.: In vitro comparison of three salbutamol-containing multidose dry powder inhalers. Clin. Drug. Invest. 2000, 20: 25-33.
43. Thorsson L., Edsbacker S., Kallen A. et al.: Pharmacokinetics and systemic activity of fluticasone via Diskus and pMDI, and of budesonide via Turbuhaler. Br. J. Clin. Pharmacol. 2001, 52: 529-538.
44. Barnes P., Virchow J., Sanchis J. et al.: Asthma management: important issues. Eur. Respir. Rev. 2005, 14: 147-151.
45. Lass J.S., Sant A., Knoch M.: New advances in aerosolised drug delivery: vibrating membrane nebuliser technology. Expert Opinion on Drug Delivery 2006, 5: 693-702.
46. Rubin B.K.: Nebulizer therapy for children: the device-patient interface. Respir. Care 2002, 47: 1314-1319.
47. Nikander K., Agertoft L., Pedersen S. et al.: Breath-synchronized nebulization diminishes the impact of patient-device interfaces (face mask or mouthpiece) on the inhaled mass of nebulized budesonide. J. Asthma 2000, 37: 451-459.
48. Nikander K., Turpeinen M., Wollmer P. et al.: Evaluation of pulsed and breath-synchronized nebulization of budesonide as a means of reducing nebulizer wastage of drug. Ped. Pulmonol. 2000, 29: 120-126.
49. Rubin B.K.: Air and soul: the science and application of aerosol therapy. Respir. Care 2010, 55: 911-921.
50. Powell H., Gibson P.: Inhaled corticosteroid doses is asthma: an evidence based approach. Med. J. Austr. 2003, 178: 223-228.
51. Global Initiative for Asthma Prevention and Treatment. GINA 2010.
52. Agertoft L., Pedersen S.: Effects of long-term treatment with an inhaled corticosteroid on growth and pulmonary function in asthmatic children. Respir. Med. 1994, 88: 373-381.
53. Knuffman J.E., Sorkness C.A., Lemanske R.F. Jr et al.: Phenotypic predictors of long-term response to inhaled corticosteroid and leukotriene modifier therapies in pediatric asthma. J. Allergy Clin. Immunol. 2009, 123: 411-416.
54. Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma. Summary Report 2007. J. Allergy Clin. Immunol. 2007, 120 (5 suppl.): S94-S138.
55. Volovitz B., Bilavsky E., Nussinovitch M.: Effectiveness of high repeated doses of inhaled budesonide or fluticasone in controlling acute asthma exacerbations in young children. J. Asthma 2008, 45: 561-567.