最近的证据表明,需要减少严重喘治疗
Eric Merrell1,2, Sandhya Khurana1,2
1Division of Pulmonary and Critical Care Medicine, University of Rochester School of Medicine and Dentistry.
Current opinion in pulmonary medicine
|February 28, 2025
概括
生物疗法对于严重的喘是有效的,但减少治疗需要更多的指导. 新出现的证据和评估工具可以帮助临床医生安全地减少对控制良好的喘患者的药物.
科学领域:
- 肺部病理学 肺部病理学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 生物疗法已经彻底改变了严重喘管理,提供了显著的好处.
- 目前的指导方针充分描述了生物启动 (step-up),但缺乏关于降级 (step-down) 的明确性.
研究的目的:
- 审查支持生物疗法减缓严重喘的证据.
- 讨论评估生物疗效和缓解的工具.
- 为减少喘治疗提出一个框架.
主要方法:
- 审查最近改变实践的证据.
- 讨论生物反应的临床评估工具.
- 关于治疗逐步下降框架的建议.
主要成果:
- 有临床工具可用于评估生物反应,并识别潜在的治疗减少患者.
- 一些患者达到临床缓解,允许安全地逐渐减少或取消附加疗法.
- 有证据支持在响应者和缓解者中降低治疗的可能性.
结论:
- 虽然共识有限,但越来越多的证据支持在缓解症患者的严重喘中放弃生物疗法.
- 需要有结构的指导来帮助临床医生管理治疗缓解控制良好的喘.
- 需要进一步的研究来完善逐步降低策略并解决临床不确定性.
相关概念视频
Asthma-IV: Diagnostic and Management
2.5K
The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
2.5K
Drugs Used in Lower Respiratory Disorders: Overview
334
Lower respiratory tract disorders present challenges that often require skilled and nuanced approaches for effective management. Common ailments, such as asthma and chronic obstructive pulmonary disease (COPD), have prompted the development of intricate treatment strategies involving bronchodilators and anti-inflammatory drugs, each tailored to ease breathing and revitalize the lungs.
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
334
Asthma-III: Symptoms and Complications
2.4K
Asthma, a common chronic respiratory condition, is classified considering the frequency and severity of symptoms alongside lung function impairment. Understanding this classification is essential for appropriate treatment and management. Here's a detailed look at the classification of asthma and its clinical features and complications:
Classification of Asthma
Classification of Asthma
2.4K
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
201
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
201
Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
222
Asthma is a chronic respiratory condition for which new therapeutic avenues, including anti-inflammatory drugs like mast cell stabilizers and anti-IgE treatments, continue to be developed.
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
222
Antiasthma Drugs: Leukotriene Modifiers
230
Leukotriene modifiers, or cysteinyl leukotriene receptor antagonists, are medications used to manage chronic asthma. These agents target specific inflammatory mediators produced during arachidonic acid metabolism, an essential process in generating inflammation in the body.
Leukotriene modifiers work through two distinct mechanisms:
Leukotriene modifiers work through two distinct mechanisms:
230


