PharmatecaPharmatecaФарматека2073-40342414-9128Bionika Media29758710.18565/pharmateca.2019.5.10-16ArticlesСтатьиResearch ArticleInhaled glucocorticosteroids in the treatment of chronic obstructive pulmonary disease: the debate continuesИнгаляционные глюкокортикостероиды в лечении хронической обструктивной болезни легких: дискуссия продолжаетсяEmelyanovAlexander V.ЕмельяновА. В

MD, Professor, Head of the Department of Pulmonology

д.м.н., профессор, зав. кафедрой пульмонологии

aleksandr.emelyanov@szgmu.ruLeshenkovaE. VЛешенковаЕ. В

Department of Pulmonology

Кафедра пульмонологии

SergeevaG. RСергееваГ. Р

Department of Pulmonology

Кафедра пульмонологии

North-Western State Medical University n.a. I.I. MechnikovСеверо-Западный государственный медицинский университет им. И.И. Мечникова15052019265VOL 26, NO5 (2019)ТОМ 26, №5 (2019)101628022023Copyright ©; 2019, Bionika MediaCopyright ©; 2019, ООО «Бионика Медиа»2019Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/2073-4034/article/view/297587

Chronic obstructive pulmonary disease (COPD) is a common disease characterized by persistent bronchial obstruction. Chronic airway inflammation, which occurs under the influence of tobacco smoke and pollutants, is important in its development and progression. The place of inhaled glucocorticosteroids (IGCS) in the treatment of COPD is one of the most controversial issues in recent years. This article discusses the role of IGCS in the treatment of COPD. The available results of clinical studies allow to recommend these drugs in case of combination of bronchial asthma and COPD. They are also indicated for patients with frequent exacerbations of COPD, despite therapy with long-acting bronchodilators and their combinations. The most likely predictor of IGCS efficacy as a part of dual (IGCS/long-acting e2-agonists [LABA]) and triple therapy (IGCS/LABA/long-acting anticholinergic agents [LAAHA]) is the frequency of exacerbations and the eosinophil blood level. Risk/benefit ratio must be taken into account in case of administration of these drugs.

Хроническая обструктивная болезнь легких (ХОБЛ) - распространенное заболевание, характеризующееся персистирующей бронхиальной обструкцией. Важное значение в ее развитии и прогрессировании имеет хроническое воспаление дыхательных путей, возникающее под влиянием табачного дыма и поллютантов. Одним из наиболее дискутабельных вопросов в последние годы является место ингаляционных глюкокортикостероидов (ИГКС) в лечении ХОБЛ. В настоящей статье обсуждается роль ИГКС в комплексной терапии ХОБЛ. Имеющиеся результаты клинических исследований позволяют рекомендовать эти препараты при сочетании бронхиальной астмы и ХОБЛ. Они также показаны пациентам с частыми обострениями ХОБЛ, несмотря на терапию длительно действующими бронхолитиками и их комбинациями. Наиболее вероятным предиктором эффективности ИГКС в составе двойной (ИГКС/длительно действующие в2-агонисты [ДДБА]) и тройной терапии (ИГКС/ДДБА/длительно действующие антихолинергические препараты [ДДАХ]) является частота обострений и уровень эозинофилов крови. При назначении этих препаратов необходимо учитывать соотношение их эффективности и безопасности.

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