pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2016-26-3-357-363pulmo-728Research ArticleОБЗОРЫREVIEWИнгаляционные глюкокортикостероиды / длительно действующие β2-агонисты в лечении хронической обструктивной болезни легких: дискуссия продолжаетсяInhaled steroids / long6acting β2-agonists in treatment of chronic obstructive pulmonary disease: the discussion goes onБарабановаЕ. Н.BarabanovaE. N.

к. м. н., менеджер по медицинс ким и научным коммуникациям ЗАО «ГлаксоСмитКляйн Трейдинг»; тел.: (495) 7778900

PhD, Medical and Scientific Communication Manager, GlaxoSmithKline Trading PLC; tel.: (495) 7778900

ekaterina.n.barabanova@gsk.comКолонтареваЮ. М.KolontarevaY. M.

медицинский менеджер респираторного направления ЗАО «ГлаксоСмитКляйн Трейдинг», тел.: (495) 7778900

Respiratory Medical Affairs Manager, GlaxoSmithKline Trading PLC; tel.: (495) 7778900

yuliya.m.kolontareva@gsk.comЗАО «ГлаксоСмитКляйн Трейдинг»: 121614, Москва, ул. Крылатская, 17, корп. 3РоссияGlaxoSmithKline Trading PLC: 17, build. 3, Krylatskaya str., Moscow, 121614, RussiaRussian Federation201627072016263357363Copyright © Барабанова Е.Н., Колонтарева Ю.М., 20162016Барабанова Е.Н., Колонтарева Ю.М.Barabanova E.N., Kolontareva Y.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/728

Хроническая обструктивная болезнь легких (ХОБЛ) является актуальной проблемой современного здравоохранения. Патогенез ХОБЛ связан с воспалением, поэтому в арсенале препаратов для лечения этого заболевания существенную роль играют противовоспалительные препараты – ингаляционные глюкокортикостероиды (иГКС). Доказаны благоприятные эффекты иГКС на исходы болезни, однако их использование может сопровождаться повышением риска развития нежелательных явлений, в частности, пневмонии. В статье приведен обзор результатов исследований, в которых продемонстрированы долгосрочные положительные эффекты применения комбинаций иГКС и длительно действующих β2"агонистов (ДДБА) у пациентов с различной степенью тяжести ХОБЛ, в т. ч. новой комбинации для однократного применения – флутиказона фуроата / вилантерола. Также рассмотрены данные о пневмонии как наиболее часто обсуждаемом неблагоприятном эффекте применения иГКС / ДДБА, приведены последние доказательства о класс"специфичности данного эффекта. Кроме того, рассмотрены последние доказательства в пользу применения нового биомаркера, потенциально способного выделить фенотип пациентов, для которых назначение иГКС"содержащих препаратов является наиболее оправданным, – таким биомаркером может быть уровень эозинофилов в крови.

Chronic obstructive pulmonary disease (COPD) is an actual healthcare problem. Inflammation is a part of pathogenesis of COPD; therefore, antiinflammatory agents including inhaled corticosteroids (ICS) play an important role in therapy of this disease. Favorable effects of ICS on outcomes of COPD were confirmed, but treatment with ICS in these patients is associated with an increased risk of adverse events, particularly pneumonia. Results of clinical trials demonstrated long"term effects of ICS and long"acting β2"agonists (LABA) in patients with different stages of COPD. Efficacy and safety of novel fluticasone furoate / vilanterol once"daily combination have been discussed in this review. Data on pneumonia as the most troubling adverse effect of ICS / LABA treatment and recent evidence on class specificity of this effect have been reviewed. Blood eosinophilia is considered as a biomarker that potentially could distinguish patients who would have more benefit from ICS prescription.

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