TherapyTherapyТерапия2412-40362713-1823Bionika Media28877310.18565/therapy.2022.1.133-141ArticlesСтатьиResearch ArticleModern treatment of bronchial asthmaАктуальные вопросы лечения бронхиальной астмыEmelyanovAlexander V.ЕмельяновАлександр Викторович

MD, professor, head of the Department of pulmonology

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

aleksandr.emelyanov@szgmu.ruLeshenkovaEvgeniya V.ЛешенковаЕвгения Владиславовна

PhD, associate professor of the Department of pulmonology

к.м.н., доцент кафедры пульмонологии

evgeniya.leshenkova@szgmu.ruSergeevaGalina R.СергееваГалина Раисовна

PhD, associate professor of the Department of pulmonology

к.м.н., доцент кафедры пульмонологии

galina.sergeeva@szgmu.ruTsukanovaInessa V.ЦукановаИнесса Витальевна

PhD, assistant at the Department of pulmonology

к.м.н., ассистент кафедры пульмонологии

tsinessa@inbox.ruI.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of RussiaФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России1501202281VOL 8, NO1 (2022)ТОМ 8, №1 (2022)13314126022023Copyright ©; 2022, “Bionika Media” LLCCopyright ©; 2022, ООО «Бионика Медиа»2022“Bionika Media” LLCООО «Бионика Медиа»https://journals.eco-vector.com/2412-4036/about/editorialPolicieshttps://journals.eco-vector.com/2412-4036/article/view/288773

Review is focused on modern treatment of asthma, one of the most prevalent and significant respiratory diseases in the world. The purpose of the review is to consider options for asthma therapy at various steps of treatment in accordance with the latest international and Russian clinical guidelines, the main groups of drugs currently recommended for the management of patients with varying severity of the disease in its stable course. In addition, the information about future therapy of asthma is provided.

В статье обсуждаются современные представления о лечении бронхиальной астмы (БА) - одного из самых распространенных и социально значимых заболеваний в мире. Цель обзора - рассмотреть варианты терапии БА на различных ступенях терапии в соответствии с последними международными и национальными клиническими рекомендациями, основные группы лекарственных препаратов, рекомендованных в настоящее время для ведения пациентов с различной тяжестью заболевания при его стабильном течении. Также обсуждаются ближайшие перспективы совершенствования фармакотерапии БА.

asthmacontrol of asthmasteps of asthma treatmentбронхиальная астмаконтроль бронхиальной астмыступенчатая терапия бронхиальной астмыGBD 2015 Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med. 2017; 5(9): 691-706. doi: 10.1016/S2213-2600(17)30293-X.Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. Updated 2021. Available at: https://ginasthma.org/wp-content/uploads/2021/05/GINA-Main-Report-2021-V2-WMS.pdf (date of access - 01.11.2021).Клинические рекомендации. Бронхиальная астма. Российское респираторное общество. Российская ассоциация аллергологов и клинических иммунологов. Союз педиатров России. 2021. Доступ: https://cr.minzdrav.gov.ru/schema/359_2 (дата обращения - 01.12.2021).Chung K., Wenzel S., Brozek J. et al.International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014; 43(2): 343-73. doi: 10.1183/09031936.00202013.Федосеев Г.Б., Трофимов В.И., Петрова М.А. Многоликая бронхиальная астма, диагностика, лечение и профилактика. С.-Петербург: Нордмедиздат. 2011; 343 с.Irwin R.S., Richardson N.D. Side effects with inhaled corticosteroids. Chest. 2006; 130(1 Suppl): 41S-53S. doi: 10.1378/chest.130.1_suppl.41S.Lacasse Y., Archibald H., Ernst P., Boulet L.P. Pattern and determinants of compliance with inhaled steroids in adults with asthma. Can Respir J. 2005; 12(4): 211-17. doi: 10.1155/2005/375454.Bousquet J., Khaltaev N., Cruz A.A. et al. Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008; 63 Suppl 86: 8-160. doi: 10.1111/j.1398-9995.2007.01620.x.O'Byrne P.M, FitzGerald J.M, Bateman E.D. et al. Inhaled combined budesonide-formoterol as needed in mild asthma. N Engl J Med. 2018; 378(20): 1865-76. doi: 10.1056/NEJMoa1715274.Bateman E.D., Reddel H.K., O'Byrne P.M. et al. As-needed budesonide-formoterol versus maintenance budesonide in mild asthma. N Engl J Med. 2018; 378(20): 1877-87. doi: 10.1056/NEJMoa1715275.Beasley R., Holliday M., Reddel H. et al. Controlled trial of budesonide-formoterol as needed for mild asthma. N Engl J Med. 2019; 380(21): 2020-30. doi: 10.1056/NEJMoa1901963.Hardy J., Baggott C., Fingleton J. et al. Budesonide-formoterol reliever therapy versus maintenance budesonide plus terbutaline reliever therapy in adults with mild to moderate asthma (PRACTICAL): A 52-week, open-label, multicentre, superiority, randomised controlled trial. Lancet. 2019; 394(10202): 919-28. doi: 10.1016/S0140-6736(19)31948-8.Sobieraj D.M., Weeda E.R., Nguyen E. et al. Association of inhaled corticosteroids and long-acting ß-agonists as controller and quick relief therapy with exacerbations and symptom control in persistent asthma. a systematic review and meta-analysis. JAMA. 2018; 319(14): 1485-96. doi: 10.1001/jama.2018.2769.Lee L.A., Bailes Z., Barnes N. et al. Efficacy and safety of once-daily single-inhaler triple therapy (FF/UMEC/VI) versus FF/VI in patients with inadequately controlled asthma (CAPTAIN): A double-blind, randomised, phase 3A trial. Lancet Respir Med. 2021; 9(1): 69-84. doi: 10.1016/S2213-2600(20)30389-1.Papi A., Singh D., Corre S. et al. Single inhaler extrafine triple therapy in uncontrolled asthma (TRIMARAN and TRIGGER): Two doubleblind, parallel-group, randomised, controlled phase 3 trials. Lancet. 2019; 394(10210): 1737-49. doi: 10.1016/S0140-6736(19)32215-9.Kerstjens H.A.M., Maspero J., Chapman K.R. et al. Once-daily, single-inhaler mometasone-indacaterol-glycopyrronium versus mometasone - indacaterol or twice-daily fluticasone-salmeterol in patients with inadequately controlled asthma (IRIDIUM): A randomised, double-blind, controlled phase 3 study. Lancet Respir Med. 2020; 8(10): 1000-12. doi: 10.1016/S2213-2600(20)30190-9.McCracken J., Tripple J., Calhoun W. Biologic therapy in the management of asthma. Curr Opin Allergy Clin Immumol. 2016; 16(4): 375-82. doi: 10.1097/ACI.0000000000000284.Pelaia C., Vatrella A., Bruni A. et al. Benralizumab in the treatment of severe asthma: design, development and potential place in therapy. Drug Des Devel Ther. 2018; 12: 619-28. doi: 10.2147/DDDT.S155307.Lugogo N., Domingo C., Chanez P. et al. Long-term efficacy and safety of mepolizumab in patients with severe eosinophilic asthma: A multi-center open-label, phase IIIb study. Clin Ther. 2016; 38(9): 2058-70.e1. doi: 10.1016/j.clinthera.2016.07.010.Castro M., Corren J., Pavord I.D. et al. Dupilumab efficacy and safety in moderate-to-severe uncontrolled asthma. N Engl J Med. 2018; 378(26): 2486-96. doi: 10.1056/NEJMoa1804092.Agache I., Akdis C.A., Akdis M. et al. EAACI Biologicals guidelines-recommendations for severe asthma. Allergy. 2021; 76(1): 14-44. doi: 10.1111/all.14425.Тяжелая бронхиальная астма. Согласительный доклад объединенной группы экспертов. Ассоциация русскоговорящих специалистов в области респираторной медицины, Российское респираторное общество, Российская ассоциация аллергологов и клинических иммунологов. 2018. Доступ: https://spulmo.ru/obrazovatelnye-resursy/federalnye-klinicheskie-rekomendatsii (дата обращения - 01.12.2021).Bousquet J., Brusselle G., Buhl R. et al. Care pathways for the selection of a biologic in severe asthma. Eur Respir J. 2017; 50(6): 1701782. doi: 10.1183/13993003.01782-2017.Menzies-Gow A., Corren J., Bourdin A. et al. Tezepelumab in adults and adolescents with severe, uncontrolled asthma. N Engl J. 2021; 384(19): 1800-09. doi: 10.1056/NEJMoa2034975.Wechsler M.E., Ruddy M.K., Pavord J.D. et al. Efficacy and safety of itepekimab in patients with moderate-to-severe asthma. N Engl J Med. 2021; 385(18): 1656-68. doi: 10.1056/NEJMoa2024257.Kelsen S.G., Agache J.O., Soong W. et al. Astegolimab (anti-ST2) efficacy and safety in adults with severe asthma: A randomized clinical trial. J Allergy Clin Immunol. 2021; 148(3): 790-98. doi: 10.1016/j.jaci.2021.03.044.Gibson P.G., Yang I.A., Upham J.W. et al. Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES): A randomised, double-blind, placebo-controlled trial. Lancet. 2017; 390(10095): 659-68. doi: 10.1016/S0140-6736(17)31281-3.Torrego A., Sola I., Munoz A.M. et al. Bronchial thermoplasty for moderate or severe persistent asthma in adults. Cochrane Database Syst Rev. 2014; 2014(3): CD009910. doi: 10.1002/14651858.CD009910.pub2.Wang L., Yin J., Fadel R. et al. House dust mite sublingual immunotherapy is safe and appears to be effective in moderate, persistent asthma. Allergy. 2014; 69(9): 1181-89. doi: 10.1111/all.12188.Virchow C., Backer V., Kuna P. et al. Efficacy of house dust mite allergen sublingual immunotherapy tablets in adults patients with allergic asthma: A randomized clinical trial. JAMA. 2016; 315(16): 1715-25. doi: 10.1001/jama.2016.3964