The response variability of the asthma patients to the standard pharmacotherapy
- Authors: Pavlova KS1, Mdinaradze DS1, Kurbacheva OM1
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Affiliations:
- NRC Institute of Immunology FMBA of Russia
- Issue: Vol 16, No 2 (2019)
- Pages: 20-24
- Section: Articles
- URL: https://journals.rcsi.science/raj/article/view/121387
- DOI: https://doi.org/10.36691/RJA1193
- ID: 121387
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Abstract
Background. The aim of this study was to analyse the group of patients with asthma, who prefer to use short-acting anticholinergics (SAMA) for relief of asthma attacks. At the same time, these patients are prescribed inhaled glucocorticosteroids (ICS) in combination with long-acting P2-agonists (LABA) as a basic therapy according to the standards. Tha aim. To study the cause of low efficacy of LABA in patients with asthma who do not have a sufficient response to SABA, as well as the probability of reducing of bronchial obstruction with LAMA. Materials and methods. 12 non-smoking adults with moderate to severe asthma (III-IV stage of GINA), receiving medium or high doses of ICS in combination with LABA as a basic therapy without adequate control over asthma symptoms were included in the study. First group of patients showed the efficacy of salbutamol (FEV1 reversibility was more than 12% and more than 200 ml after 400 ^g of salbutamol) and ipratropium bromide (SABA+SAMA+). Second group included patients with low response to salbutamol and positive test (FEVt reversibility) with ipratropium bromide (SABA-SAMA+). Spirometry was performed at baseline point and in 5, 10, 15, 30, 60, 120 and 240 min after inhalation of bronchodilator (salmeterol 50 ^g, formoterol 12 ^g and tiotropium bromide 18 ^g in the different days). Results. It was shown that SABA-SAMA+ phenotype asthma patients demonstrated low response to LABA: FEV1 increased up to 7.64±1.67%, 156.0±16.0 ml after salmeterol inhalation and up to 9.4±5.8%, 166.7±103.1 ml after formoterol inhalation (compared with a group of SABA+SAMA+, where the response to salmeterol was 20.81±2.42%, 551.43±93.94 ml and the response to formoterol was 30.21±6.75%, 718.57±140.78 ml, p<0.05), and a good response to LAMA (13.7±5.8% and 250.0±61.6). Conclusion. The results of the study allowed to define asthma phenotype with low bronchial obstruction reversibility to SABA and sufficient reversibility to SAMA (SABA-SAMA+). This group of asthma patients need the basic treatment with the combination of ICS and LABA and LAMA (tiotropium bromide).
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##article.viewOnOriginalSite##About the authors
K S Pavlova
NRC Institute of Immunology FMBA of Russia
Email: ksenimedical@gmail.com
кандидат медицинских наук, старший научный сотрудник отделения бронхиальной астмы.
D S Mdinaradze
NRC Institute of Immunology FMBA of Russiaординатор отделения бронхиальной астмы.
O M Kurbacheva
NRC Institute of Immunology FMBA of Russiaпрофессор, доктор медицинских наук, зав. отделением бронхиальной астмы.
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