Efficacy and safety of different combined therapeutic modes in patients with severe uncontrollable bronchial asthma
Abstract
Comparative randomized opened study involved 50 patients with brittle phenotype of severe asthma. The purpose of study was to compare efficacy and safety of different combined therapeutic modes in patients with severe uncontrollable asthma. The research consisted of 2 stages: initial 10-week treatment (beclomethasone 1500 meg daily) and actually investigation of different modes of combined 20-week therapy (Seretid Multidisk 250/50 2 inhaled doses daily; Flixotide 2000 meg daily; Flixotide 1000 meg daily + long-acting theophylline; Flixotide 1000 meg daily + leucotrien antagonists; Seretide Multidisk 250/50 2 inhaled doses daily and minimal effective doses of prednisolone). The evaluation of the asthma control level was assessed with E.Bateman's criteria. The safety of the drugs was estimated by questions, electrocardiogram data, serum potassium and cortisol levels.
The combined therapy with Seretid Multidisk demonstrated the high efficacy and safety when compared with other investigated therapeutic modes.
About the Authors
L. M. OgorodovaRussian Federation
O. S. Kobiakova
Russian Federation
F. I. Petrovsky
Russian Federation
U. V. Ivanova
Russian Federation
F. M. Khanova
Russian Federation
I. A. Deev
Russian Federation
N. P. Kraiushkina
Russian Federation
Yu. A. Petrovskaya
Russian Federation
T. V. Smetanenko
Russian Federation
L. Yu. Reutova
Russian Federation
References
1. Огородова Л.М., Кобякова О.С., Петровский Ф.И. и др. Global asthma control: возможно ли достижение целей терапии? (результаты исследования в группе больных среднетяжелой бронхиальной астмой). Аллергология 2001; 1: 15-21.
2. Огородова Л.М., Петровский Ф.И., Петровская Ю.А., Кобякова О.С. Клиническая фармакология ингаляционных кортикостероидов: Пособие для врачей. Томск; 2001.
3. Петров В.И., Смоленое И.В., Смирнов Н.А. Безопасность и побочные эффекты ингаляционных кортикостероидов у детей с бронхиальной астмой. Пульмонология 1998; 3: 88-95.
4. Смоленое И.В. Безопасность ингаляционных кортикостероидов: новые ответы на старые вопросы. Атмосфера. Пульмонол. и аллергол. 2002; 3: 10-15.
5. Страчунский Л.С., Козлов С.И. Глюкокортикоидные препараты: Пособие для врачей. Смоленск; 1997.
6. Цой А.И. Клиническая фармакология ингаляционных глюкокортикостероидов. Пульмонология 1996; 2: 85-90.
7. Чучалин А.Г. Тяжелая бронхиальная астма. Рус. мед. журн. 2000; 8 (12): 482-486.
8. Baraniuk J., Murray J.J., Nathan R.A. Fluticasone alone or in combination with salmeterol vs triamcinolone acetonide in asthma. Chest 1999; 116: 625.
9. Bateman E. D., Bousquet J., Braunstein G.L. Is overall asthma control being achieved? A hypothesis-generating study. Eur. Respir. J. 2001; 17: 589-595.
10. Busse W.W., Nelson J., Wolfe J. Comparison of inhaled salmeterol and oral zafirlukast in patients with asthma. J. Allergy Clin. Immunol. 1999; 103: 1075.
11. Difficult/therapy-resistant asthma. ERS Task Force on Difficult/therapy-resistant asthma. Eur. Respir. J. 1999; 13: 1198.
12. Global initiative for asthma. Global strategy for asthma management and prevention: NHI.BI/W HO workshop report. No. 95-3659. National Institutes of Health. 1995.
13. Greening A.P., Jnd P.W., Northfield М., Shaw G. Added salmeterol versus higher-dose corticosteroid in asthma patients with symptoms on existing inhaled corticosteroid. Lancet 1994; 344: 219.
14. Kamada A.K., Szefler S.J., Martin R.J. et al. and the Asthma Clinical Research Network. Issues in the use of inhaled glucocorticoids. Am. J. Respir. Crit. Care Med. 1996; 153: 1739-1748.
15. Markham A., Adkins J.C. Inhaled salmeterol/fluticasone propionate combination. A pharmacoeconomic review of use in the management of asthma. Pharmacoeconomics 2000; 105: 162.
16. National asthma education and prevention program. Expert panel report 2: Guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute, National Institutes of Health. Publ. № 97-4051. Bethesda, MD; 1997.
17. Nielsen L.P., Dahl R. Therapeutic ratio of inhaled corticosteroids in adult asthma. A dose-range comparison between fluticasone propionate and budesonide, measuring their effect on bronchial hyperresponsiveness and adrenal cortex function. Am. J. Respir. Crit. Care Med. 2000; 162 (6): 2053-2057.
18. Shewsbury S., Pyke S., Britton M. A meta-analysis of increasing inhaled steroid or adding salmeterol in symptomatic asthma (MIASMA). Br. Med. J. 2000; 320: 1368.
19. Staresinic A.G., Sorkness C.A. Fluticasone propionate: a potent inhaled corticosteroid for the treatment of asthma. Expert Opin. Pharmacother. 2000; 1 (6): 1227-1244.
Review
For citations:
Ogorodova L.M., Kobiakova O.S., Petrovsky F.I., Ivanova U.V., Khanova F.M., Deev I.A., Kraiushkina N.P., Petrovskaya Yu.A., Smetanenko T.V., Reutova L.Yu. Efficacy and safety of different combined therapeutic modes in patients with severe uncontrollable bronchial asthma. PULMONOLOGIYA. 2003;(1):75-79. (In Russ.)