Modern treatment of mild asthma


DOI: https://dx.doi.org/10.18565/therapy.2019.6.139-142

Emelyanov А.V., Leshankova E.V., Sergeeva G.R., Partavi M.S.

I.I. Mechnikov North-Western State medical University of the Ministry of Healthcare of Russia
Mild asthma is the most common form of this disease, which significantly reduces the quality of life of patients and may associate with severe and fatal exacerbations. One of the most significant barrier to achieving asthma control is the low adher-ence of patients to regular therapy with low doses of inhaled glucocorticoids (ICS). The results of recent clinical trials allow to recommend as needed use of ICS /formoterol combination as a preferred treatment of mild asthma. Current stepwise approach excludes monotherapy with short-acting β2-adrenergic agonists. Role of antileukotrienes, allergen-specific immunotherapy and patient education in the treatment of patients with mild asthma are discussed.
Keywords: mild asthma, treatment
Read entire article

Literature


  1. Dusser D., Montani D., Chanez P. et al. Mild asthma: an expert review on epidemiology, clinical characteristics and treatment recommendations. Allergy. 2007; 62 (6): 591–604.

  2. Global Strategy for Asthma Management and Prevention. Revised 2019. https://www.ginasthma.org (Accessed date: 30.08.2019).

  3. Федеральные клинические рекомендации по бронхиальной астме 2019 г. http://spulmo.ru/upload/kr_bronhastma_2019.pdf (дата обращения: 30.08. 2019).

  4. Stanford R.H., Shah M.B., D’Souza A.O. et al. Short-acting β-agonist use and its ability to predict future asthma-related outcomes. Ann Allergy Asthma Immunol. 2012; 109(6): 403–07.

  5. Anderson H.R., Ayres J.G., Sturdy P.M. et al. Bronchodilator treatment and deaths from asthma: case-control study. BMJ. 2004; 330(7483): 117.

  6. Pauwels R.A., Pedersen S., Busse W.W. et al. START Investigators Group. Early intervention with budesonide in mild persistent asthma: a randomised, double-blind trial. Lancet. 2003; 361 (9363):1071–76.

  7. O’Byrne P.M., Barnes P.J., Rodriguez-Roisin R. et al. Low dose inhaled budesonide and formoterol in mild persistent asthma: the OPTIMA randomized trial. Am J Respir Crit Care Med. 2001; 164 (8 Pt 1): 1392–97.

  8. Reddel H.K., Busse W.W., Pedersen S. et al. Should recommendations about starting inhaled corticosteroid treatment for mild asthma be based on symptom frequency: a post-hoc efficacy analysis of the START study. Lancet. 2017; 389(10065): 157–66.

  9. O’Byrne P.M., Pedersen S., Lamm C.J. et al. START Investigators Group. Severe exacerbations and decline in lung function in asthma. Am J Respir Crit Care Med. 2009; 179(1): 19–24.

  10. Nathan R.A., Thompson P.J., Price D. et al. Taking aim at asthma around the world: global results of the asthma insight and management survey in the Asia-Pacific region, Latin America, Europe, Canada, and the United States. J Allergy Clin Immunol Pract. 2015; 3(5): 734–42. e5.

  11. Plakas S., Mastrogiannis D., Mantzorou M. et al. Validation of the 8-item Morisky medication adherence scale in chronically ill ambulatory patients in rural Greece. Open J Nurs. 2016; 6: 158–69.

  12. Bender B.G., Rankin A., Tran Z.V., Wamboldt F.S. Brief-interval telephone surveys of medication adherence and asthma symptoms in the Childhood Asthma Management Program Continuation Study. Ann Allergy Asthma Immunol. 2008; 101 (4): 382–86.

  13. Papi A., Canonica G.W., Maestrelli P. et al. BEST Study Group. Rescue use of beclomethasone and albuterol in a single inhaler for mild asthma. N Engl J Med. 2007; 356(20): 2040–52.

  14. O’Byrne P.M., FitzGerald J.M., Bateman E.D. et al. Inhaled combined budesonide–formoterol as needed in mild asthma. N Engl J Med. 2018; 378(20): 1865–76.

  15. Bateman E.D., Reddel H.K., O’Byrne P.M. et al. As-needed budesonide–formoterol versus maintenance budesonide in mild asthma. N Engl J Med. 2018; 378(20): 1877–87.

  16. Beasley R., Holliday M., Reddel H.K. et al. Novel START Study Team. Controlled Trial of Budesonide–Formoterol as Needed for Mild Asthma. N Engl J Med. 2019; 380(21): 2020–30.

  17. Wang L., Yin J., Fadel R. et al. House dust mite sublingual immunotherapy is safe and appears to be effective in moderate, persistent asthma. Allergy. 2014; 69(9):1181–88.

  18. Virchow J.C., Backer V., Kuna P. et al. Efficacy of house dust mite allergen sublingual immunotherapy tablets in adults patients with allergic asthma. A randomized clinical trial. JAMA. 2016; 315(16): 1715–25.

  19. Lee J., McDonald C. Review: Immunotherapy improves some symptoms and reduces long-term medication use in mild to moderate asthma. Ann Intern Med. 2018; 169(4): JC17.


About the Autors

Alexander V. Emelyanov, MD, professor, head of the Department of pulmonology of I.I. Mechnikov North-Western State medical University of the Ministry of Healthcare of Russia. Address: 191015, St. Petersburg, 41 Kirochnaya Str. Tel.: +7 (812) 970-71-88. E-mail: aleksandr.emelyanov@szgmu.ru
Evgenia V. Leshenkova, PhD, associate professor of the Department of pulmonology of I.I. Mechnikov North-Western State medical University of the Ministry of Healthcare of Russia. Address: 191015, St. Petersburg, 41 Kirochnaya Str. Tel.: +7 (812) 970-72-14. E-mail: leshenkova@ mail.ru
Galina R. Sergeeva, PhD, associate professor of the Department of pulmonology of I.I. Mechnikov North-Western State medical University of the Ministry of Healthcare of Russia. Address: 191015, St. Petersburg, 41 Kirochnaya Str. Tel.: +7 (812) 970-72-14. E-mail: sergeevagr@mail.ru
Muhiddin S. Partavi, graduate student of the Department of pulmonology of I.I. Mechnikov North-Western State medical University of the Ministry of Healthcare of Russia. Address: 191015, St. Petersburg, 41 Kirochnaya Str. Tel.: +7 (812) 970-72-14. E-mail: partavi.muhiddin@mail.ru


Similar Articles

Back to Content

Бионика Медиа