pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2014-0-6-83-93pulmo-497Research ArticleОБЗОРЫREVIEWРежим единого ингалятора в ступенчатой терапии бронхиальной астмы: изменения GINA 2014Single inhaler strategy in stepwise therapy of bronchial asthma: GINA 2014 updateНенашеваН. М.NenashevaN. M.

д. м. н., профессор кафедры клинической аллергологии ГБОУ ДПО "Российская медицинская академия последипломного образования" Минздрава России; тел.: (499) 196-17-86

MD, Professor of Chair of Clinical Allergology, State Budget Educational Institution of Аdditional Еducation "Russian Medical Postgraduate Academy", Healthcare Ministry of Russia; tel.: (499) 196-17-86

1444031@gmail.comГБОУ ДПО "Российская медицинская академия последипломного образования" Минздрава России: 123995, Москва, ул. Баррикадная, 2 / 1РоссияState Institution of Аdditional Еducation "Russian Medical Postgraduate Academy", Healthcare Ministry of Russia, 2 / 1, Barrikadnaya ul., Moscow, 123995, Russia SummaryRussian Federation201428122014068393Copyright © Ненашева Н.М., 20142014Ненашева Н.М.Nenasheva N.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/497

Рассматриваются некоторые основные изменения в Глобальной инициативе по бронхиальной астме (БА) (Global Initiative for Asthma – GINA, 2014), касающиеся определения, фенотипов и ступенчатой терапии БА. Обсуждается обоснование применения режима единого ингалятора с помощью препарата будесонид / формотерол в ступенчатой терапии БА, являющегося, наряду с применением ингаляционных кортикостероидов и β2-агонистов длительного действия в качестве поддерживающей терапии + β2-агонисты короткого действия по потребности, предпочтительным выбором при контролирующей терапии БА у взрослых и подростков на ступенях лечения 3–4 (GINA). 

Major advances of GINA (Global Initiative for Asthma) 2014 pertinent to definition, phenotypes and stepwise approach for adjusting treatment of asthma have been viewed in the article. The attention was focused on combinations of low-dose inhaled steroid (ICS) / formoterol (FOR) both as maintenance and reliever therapy (single inhaler strategy) or ICS / long-acting β2-agonist (LABA) as maintenance therapy plus short-acting β2-agonist (SABA) as-needed that are preferred options for treatment steps 3–4 in adults and adolescents. GINA experts emphasize that the single inhaler strategy is the treatment of choice for asthma patients with steps 3–4 experienced ≥ 1 exacerbation during the previous year. Administration of budesonide (BUD) / FOR as a single inhaler is recommended for patients > 18 years old with insufficient asthma control and frequent need in SABA. BUD / FOR as a single maintenance and reliever inhaler could reduce frequency of severe asthma exacerbations requiring hospitalizations and use of systemic steroids, improve asthma symptoms and lung function when compared to other treatment regimens. Preventive effects of BUD / FOR combination are provided by anti-inflammatory effect which is timely amplified by additional inhalations of the drug. 

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The authors declare that there are no conflicts of interest present.