Triple combinations in asthma therapy: for whom and when: a clinical case

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Abstract

According to clinical guidelines, patients with bronchial asthma (BA) who have not achieved control on therapy with medium and high doses of inhaled glucocorticosteroids (IGCS) in combination with long-acting β2-adrenoreceptor agonists (LABA) and the presence of one or more exacerbations over the past year are recommended to be prescribed a fixed triple combination of IGCS/LABA/long-acting muscarinic receptor antagonist (LAMA). The presented clinical case justifies the escalation of basic therapy in patients with severe bronchial asthma when the dual combination (IGCS/LABA) is ineffective, to a fixed triple combination of IGCS/LABA/LAMA (mometasone/indacaterol/glycopyrronium bromide). The feature of the presented clinical case is the presence of fixed bronchial obstruction and obesity in the patient. Therapy with a fixed triple combination led to an improvement in the patient’s condition, including increased exercise tolerance, a decrease in the frequency of asthma attacks and improved spirometry. No side effects were registered. Based on the above, the following conclusions were made: the fixed triple combination of mometasone/indacaterol/glycopyrronium bromide is highly effective, safe for the patient, a single daily dose of the drug improves adherence to therapy.

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About the authors

Elena V. Bolotova

Kuban State Medical University

Author for correspondence.
Email: bolotowa_e@mail.ru
ORCID iD: 0000-0001-6257-354X

Dr. Sci. (Med.), Professor, Professor at the Department of Therapy No. 1

Russian Federation, Krasnodar

Larisa V. Shulzhenko

Kuban State Medical University; Research Institute – Regional Clinical Hospital No. 1 named after S.V. Ochapovsky

Email: larisa_shulzhenko@mail.ru
ORCID iD: 0000-0002-2110-0970

Dr. Sci. (Med.), Head of the Department of Pulmonology, Faculty of Advanced Training and Postgraduate Training of Specialists, Kuban State Medical University; Head of the Department of Pulmonology, Research Institute – Regional Clinical Hospital No. 1 named after S.V. Ochapovsky

Russian Federation, Krasnodar; Krasnodar

Oksana V. Bozhko

Research Institute – Regional Clinical Hospital No. 1 named after S.V. Ochapovsky

Email: ice_oksi@mail.ru
ORCID iD: 0000-0002-8273-7326

Pulmonologist of the Highest Qualification Category of the Department of Pulmonology

Russian Federation, Krasnodar

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