采用多重吸入器三联疗法的哮喘患者的临床特征、治疗模式和依从性:研究结果综述。

IF 2.9 3区 医学 Q2 RESPIRATORY SYSTEM Expert Review of Respiratory Medicine Pub Date : 2022-11-01 Epub Date: 2023-01-17 DOI:10.1080/17476348.2023.2167715
Mario Cazzola, Luigino Calzetta, Barbara Rinaldi, Vito De Novellis, Paola Rogliani, Maria Gabriella Matera
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引用次数: 0

摘要

简介:使用多吸入器(MITT)或单吸入器(SITT)给予吸入性皮质激素(ICS)、长效β2-受体激动剂(LABA)和长效毒蕈碱拮抗剂(LAMA)的三联疗法治疗哮喘的价值得到了越来越多证据的支持,尽管有关使用MITT的研究仍然有限:哮喘患者使用 MITT 的相关临床特征、治疗模式、疾病负担以及持续性/依从性。对MEDLINE数据库进行了检索,以确定从开始到2022年10月的参考文献:专家观点:尽管MITT能改善肺功能并降低严重恶化的发生率,但哮喘患者使用MITT的频率并不高。这可能是由于人们担心使用不同的设备会影响治疗的依从性和持久性,从而对治疗效果产生负面影响,以及担心患者会停用 ICS/LABA 而不停用 LAMA。尽管如此,尽管目前的趋势倾向于 SITT 方法,但一些医生可能会倾向于处方 MITT,而不是 SITT,因为 MITT 允许增加或减少三联疗法中单个成分的滴定。因此,显然有必要开展务实的实际研究,记录何时应首选 SITT,何时应使用 MITT。
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Clinical characteristics, treatment patterns and adherence in patients with asthma on multiple inhaler triple therapy: a review of findings.

Introduction: The value of treating asthma with the triple regimen of inhaled corticosteroid (ICS), long-acting β2-agonist (LABA), and long-acting muscarinic antagonist (LAMA) delivered using multiple inhalers (MITT), or a single inhaler (SITT) is supported by a growing body of evidence, although research is still limited regarding the use of MITT.

Areas covered: Clinical characteristics, treatment patterns, disease burden, and persistence/adherence associated with MITT use in asthma. The MEDLINE database was searched to identify references from inception until October 2022.

Expert opinion: The use of MITT is not very frequent in asthma patients, although it improves lung function and reduces the incidence of severe exacerbations. This may be due to existing concerns about using different devices on adherence and persistence to treatment, with a negative influence on outcomes, and to the fear that the patient will discontinue ICS/LABA but not LAMA. Nevertheless, although the current trend favors the SITT approach, some physicians may be induced to prescribe MITT over SITT because it allows the titration of individual components of triple therapy to be increased or decreased. Therefore, there is an evident need for pragmatic real-life studies to document when to prefer SITT and when MITT should be used.

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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
90
期刊介绍: Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity
期刊最新文献
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