Место фиксированной комбинации будесонид / формотерол в лечении хронической обструктивной болезни легких стабильного течения. Заключение совета экспертов Приволжского федерального округа Российской Федерации

Несмотря на появление новых препаратов для лечения пациентов с хронической обструктивной болезнью легких (ХОБЛ), в настоящее время нерешенными проблемами в терапии этого заболевания остаются поздняя диагностика и выявление ХОБЛ уже на стадии тяжело протекающего заболевания, высокий риск обострений, низкая комплаентность пациентов, побочное действие лекарственных средств. Персонализированная медицина требует четких показаний, предикторов эффективности и безопасности лечения. Терапия фиксированной комбинацией будесонид / формотерол рекомендована пациентам с сочетанием бронхиальной астмы (БА) и ХОБЛ; высоким уровнем эозинофилов в периферической крови (> 300 клеток в 1 мкл крови) при исключении других причин (гельминты, лямблии и т. п.) и с постбронходилатационным объемом форсированного выдоха за 1-ю секунду (ОФВ1) < 50 %долж.; бронхитическим фенотипом; ≥ 2 обострениями в предшествующий год; ≥ 1 госпитализацией по поводу обострения в течение 1 года при наличии постбронходилатационного ОФВ1 < 50 %долж. Фиксированная комбинация будесонид / формотерол не рекомендуется к регулярному назначению при эмфизематозном фенотипе ХОБЛ у больных с редкими обострениями (< 2 / без госпитализаций за предшествующий год).

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