吸入性皮质类固醇在支气管炎症中的使用:来自欧洲支气管炎症注册表 (EMBARC) 的数据
Jennifer Pollock1, Eva Polverino2,3, Raja Dhar4
1Division of Respiratory Medicine and Gastroenterology, University of Dundee, Dundee, UK.
Thorax
|March 23, 2025
概括
吸入性皮质类固醇 (ICS) 经常用于支气管切除症患者,即使不建议使用. 然而,ICS可能会减少患有高血中乙氨基酸细胞计数的患者的恶化.
科学领域:
- 肺部病理学 肺部病理学
- 临床医学 临床医学
- 呼吸道疾病 呼吸道疾病
背景情况:
- 目前的指导方针建议在支气管切除中不使用吸入性皮质类固醇 (ICS),除非患有喘,过敏性支气管肺 (ABPA) 或慢性阻塞性肺病 (COPD).
- 这项研究调查了欧洲支气管切除症患者在现实世界中使用ICS的情况.
研究的目的:
- 描述ICS在一个大型欧洲支气管切除症患者队列中使用的流行率和模式.
- 检查ICS使用与临床结果之间的关联,包括恶化,住院和死亡率.
- 为了调查血中高氨基酸细胞的数量是否会改变ICS对恶化的影响.
主要方法:
- 分析了欧洲支气管病例登记 (2015-2022) 中19324名支气管病患者的数据.
- 患者在基线被分为ICS用户或非用户.
- 临床特征,结局 (恶化,住院,死亡率) 和血中乙氨基酸细胞计数的影响在长达5年的时间内进行了评估.
主要成果:
- 超过一半的支气管切除症患者 (52.3%) 在基线处方ICS; 32.7% 即使排除了患有喘,ABPA或COPD的患者.
- 在欧洲各国,ICS的使用率大大不同 (17%-85%).
- ICS使用者通常患有更严重的疾病,但整体而言,并没有显示出恶化或住院的风险降低. 在ICS使用者中,血中异氨基细胞升高 (RR 0.70) 的恶化频率显著降低.
结论:
- 吸入性皮质类固醇的使用在支气管切除症患者中很普遍,超过目前的指导方针建议.
- ICS可能有助于降低支气管切除症患者的恶化频率,因为这些患者的血中异氨基细胞数量增加.
关键词:
支气管切除症是一种支气管切除症.
相关概念视频
01:26COPD: Management Using Bronchodilators and Corticosteroids
170
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
170
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
190
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...
190
01:23Inhaled Medications
216
Inhaled medications are crucial for managing chronic obstructive pulmonary disease (COPD) and asthma. They are essential for effective treatment and control, ensuring optimal respiratory health and well-being. Inhaled medication delivers drugs directly to the lungs, providing a rapid onset of action and reducing systemic side effects compared to oral or injectable medications. Three primary types of inhalation devices are used to administer these medications: nebulizers, metered-dose inhalers...
216
01:17Drugs Used in Lower Respiratory Disorders: Overview
333
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...
333
01:30Asthma-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
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
92
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
92