Monatsschrift Kinderheilkunde

, Volume 158, Issue 10, pp 976–986

Asthmakontrolle

Rolle der Kombinationstherapie mit inhalativen Kortikosteroiden und lang wirksamen β2-Sympathomimetika bei Kindern und Jugendlichen
  • M. Gappa
  • A. Schuster
  • C.P. Bauer
  • F. Friedrichs
  • W. Kamin
  • K. Paul
  • E. Rietschel
  • G. Steinkamp
  • E. von Mutius
  • U. Wahn
Konsensuspapiere
  • 298 Downloads

Zusammenfassung

Im vorliegenden Beitrag wird das in den internationalen Leitlinien eingeführte Konzept der Asthmakontrolle zur Steuerung der Langzeittherapie vorgestellt, das eine Behandlung gemäß Stufenplan je nach Grad der Asthmakontrolle vorsieht. Zur Beurteilung Letzterer stehen einfache, inzwischen auch für das Kindesalter validierte, kurze Fragebögen wie der Asthmakontrolltest zur Verfügung. Inhalative Kortikosteroide (ICS) sind weiterhin als Basis der antiinflammatorischen Therapie anzusehen. Kinder mit unzureichend kontrolliertem Asthma unter einer Monotherapie mit sicher dosierten ICS können gleichzeitig mit einem lang wirksamen inhalativen β2-Sympathomimetikum behandelt werden. Dabei gibt es Gründe, festen Wirkstoffkombinationen aus Gründen der Compliance den Vorzug zu geben, ihre Art und Dosierung müssen jedoch regelmäßig an die Asthmakontrolle angepasst werden, um eine langfristige Übertherapie zu vermeiden.

Schlüsselwörter

Konzept der Asthmakontrolle  Asthmakontrolltest  Langzeittherapie Inhalative Kortikosteroide Lang wirksames β2-Sympathomimetikum 

Asthma management

The role of inhaled corticosteroid and long-working β2-agonist combination therapy in children and adolescents

Abstract

The current article presents the concept of asthma control introduced in national and international guidelines, which envisages treatment according to a step-wise plan depending on the degree of asthma control. To assess the latter, short and simple questionnaires, such as the Asthma Control Test, are available and also validated for use in children. Inhaled corticosteroids (ICS) are still considered the basis of antiinflammatory therapy. Children with poorly controlled asthma under monotherapy with safely dosed ICS may be treated concurrently with a long-acting inhaled β2-agonist. In this context, fixed combinations of active substances should be preferred for reasons of compliance, while type and quantity should be adjusted to asthma control regularly in order to avoid long-term overtreatment.

Keywords

Concept of asthma control Asthma control test  Long-acting therapy Inhaled corticosteroids Long-working β2-agonist 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • M. Gappa
    • 1
  • A. Schuster
    • 2
  • C.P. Bauer
    • 3
  • F. Friedrichs
    • 4
  • W. Kamin
    • 5
  • K. Paul
    • 6
  • E. Rietschel
    • 7
  • G. Steinkamp
    • 8
  • E. von Mutius
    • 9
  • U. Wahn
    • 10
  1. 1.Klinik für Kinder und JugendmedizinMarienhospital Wesel gGmbHWeselDeutschland
  2. 2.Universitätsklinikum DüsseldorfKlinik für Kinder- und JugendmedizinDüsseldorfDeutschland
  3. 3.Kinderfachklinik Gaißach der LVA OberbayernGaißach Deutschland
  4. 4.Kinderarztpraxis LaurensbergAachenDeutschland
  5. 5.Pädiatrie/KinderheilkundeKlinik für Kinder- und Jugendmedizin, Ev. Krankenhaus Hamm gGmbHammDeutschland
  6. 6.Praxis PaulBerlinDeutschland
  7. 7.KinderklinikUniversität KölnKölnDeutschland
  8. 8.Medizinisch-wissenschaftliches PublizierenSchwerinDeutschland
  9. 9.Kinderklinik und Poliklinik, Dr. von Haunersches KinderspitalLudwig-Maximilians-Universität MünchenMünchenDeutschland
  10. 10.Abteilung Pneumologie und Immunologie, Charité-Universitätsmedizin BerlinCampus Virchow-KlinikumBerlinDeutschland

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