Email this article Possibility of achieving and maintaining asthma control in patients with bronchial cold hyperreactivity
- Authors: Kolosov VP1, Pirogov AB1, Perel'man I.M1, Mal'tseva TA1, Prikhod'ko AG1
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Affiliations:
- ФГБУ "Дальневосточный научный центр физиологии и патологии дыхания" СО РАМН, Благовещенск
- Issue: Vol 86, No 3 (2014)
- Pages: 40-44
- Section: Editorial
- URL: https://journal-vniispk.ru/0040-3660/article/view/31448
- ID: 31448
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Abstract
AIM: To evaluate the clinical efficiency of tactics to widen the scope of monotherapy with inhaled glucocorticosteroids (IGCS) in asthmatic patients with bronchial cold hyperreactivity (BCHR) during winter to achieve control of the disease in real clinical practice/MATERIAL AND METHODS: An open-label longitudinal study was conducted in a cold period in 106 asthmatics divided into 2 groups: 1) those with BCHR and 2) those with unchanged bronchial reactivity to a cold stimulus. The study involved monitoring the symptoms by the asthma control test, peak expiratory flow rate (PEFR), and spirometry results before and after cold bronchoprovocation testing; assessment of the pattern of bronchial inflammation from the ratios of induced sputum (IS) cell populations; and estimation of the number of asthma exacerbations and emergency care recourses. Group 1 used a stepwise increase of the scope of basic therapy with beclomethasone dipropionate 1000 µg/day until asthma control was achieved, which was followed by the therapy with the stable dose. Group 2 received monotherapy with beclomethasone dipropionate as the stable dosage of ≥500 µg/day/RESULTS: After the first 12 weeks of a follow-up, Group 1 showed the most marked positive changes in the intensity of clinical symptoms, forced expiratory volume in one second, and PEFR that remained within the following 12 weeks during the continued therapy with the stable dose of the drug. A preponderance of the eosinophilic and neutrophilic pattern of inflammation was seen in the patients of this group. By the end of the study, there was a decline in the number of IS inflammatory cells. A discriminant model was developed as a tool to predict asthma control achievement in patients with BCHR/CONCLUSION: A stepwise increase in the scope of IGCS monotherapy in asthmatic patients with BCHR during winter can yield the results of disease control and the incidence of exacerbations, which are similar to those seen in asthmatics with no signs of BCHR (53 and 49%, respectively).
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##article.viewOnOriginalSite##About the authors
V P Kolosov
ФГБУ "Дальневосточный научный центр физиологии и патологии дыхания" СО РАМН, Благовещенск
A B Pirogov
ФГБУ "Дальневосточный научный центр физиологии и патологии дыхания" СО РАМН, Благовещенск
Iu M Perel'man
ФГБУ "Дальневосточный научный центр физиологии и патологии дыхания" СО РАМН, Благовещенск
Email: jperelman@mail.ru
T A Mal'tseva
ФГБУ "Дальневосточный научный центр физиологии и патологии дыхания" СО РАМН, Благовещенск
A G Prikhod'ko
ФГБУ "Дальневосточный научный центр физиологии и патологии дыхания" СО РАМН, Благовещенск
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