Advertisement

Pneumo News

, Volume 11, Issue 7, pp 27–30 | Cite as

Chronisch obstruktive Lungenerkrankung

Für wen noch inhalative Steroide?

  • Johannes KrönigEmail author
  • Andreas Klemmer
  • Claus F. Vogelmeier
fortbildung
  • 16 Downloads

Die inhalative Therapie bei COPD-Patienten entspricht aktuell nicht immer den Leitlinien. Inhalierbare Glukokortikoide sollten nur in bestimmten Konstellationen zum Einsatz kommen. Diese Empfehlung beruht auf Studien, die den Einfluss der Therapie auf Lungenfunktion, Exazerbationen, Mortalität und Lebensqualität untersuchten. In Zukunft wird eine zunehmende Personalisierung den Einsatz dieser Medikation auf besser identifizierbare Patientenkollektive begrenzen. Welches Vorgehen wird derzeit als sinnvoll und praktikabel angesehen?

Literatur

  1. 1.
    Graf J, Jörres RA, Lucke T et al. Medical Treatment of COPD. Dtsch Ärztebl Int. 2018;155(37):599–605Google Scholar
  2. 2.
    Vogelmeier C, Buhl R, Burghuber O et al. Leitlinie zur Diagnostik und Therapie von Patienten mit chronisch obstruktiver Bronchitis und Lungenemphysem (COPD). Pneumologie. 2018;72(4):253–308CrossRefGoogle Scholar
  3. 3.
    Agusti A, Fabbri LM, Singh D et al. Inhaled corticosteroids in COPD: friend or foe? Eur Respir J. 2018;52(6).  https://doi.org/10.1183/13993003.01219-2018CrossRefGoogle Scholar
  4. 4.
    Pauwels RA, Löfdahl CG, Laitinen LA et al. Long-term treatment with inhaled budesonide in persons with mild chronic obstructivepulmonary disease who continue smoking. European Respiratory Society Study on ChronicObstructive Pulmonary Disease. N Engl J Med. 1999;340(25):1948–53CrossRefGoogle Scholar
  5. 5.
    Papi A, Vestbo J, Fabbri L et al. Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructivepulmonary disease (TRIBUTE): a double-blind, parallel group, randomised controlled trial. Lancet. 2018;391(10125):1076–84CrossRefGoogle Scholar
  6. 6.
    Lipson DA, Barnhart F, Brealey N et al. Once-Daily Single-Inhaler Triple versus Dual Therapy in Patients with COPD. N Engl J Med. 2018;378(18):1671–80CrossRefGoogle Scholar
  7. 7.
    Wedzicha JA, Banerji D, Chapman KR et al. Indacaterol-Glycopyrronium versus Salmeterol-Fluticasone for COPD. N Engl J Med. 2016;374(23):2222–34CrossRefGoogle Scholar
  8. 8.
    Calverley PM, Anderson JA, Celli B et al. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med. 2007;356(8):775–89CrossRefGoogle Scholar
  9. 9.
    Vestbo J, Anderson JA, Brook RD et al. Fluticasone furoate and vilanterol and survival in chronic obstructive pulmonary disease with heightened cardiovascular risk (SUMMIT): a double-blind randomised controlled trial. Lancet. 2016;387(10030):1817–26CrossRefGoogle Scholar
  10. 10.
    Yang IA, Clarke MS, Sim EH, Fong KM. Inhaled corticosteroids for stable chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2012;(7):CD002991.  https://doi.org/10.1002/14651858.CD002991.pub3
  11. 11.
    Vestbo J, Leather D, Diar Bakerly N et al. Effectiveness of Fluticasone Furoate-Vilanterol for COPD in Clinical Practice. N Engl J Med. 2016;375(13):1253–60CrossRefGoogle Scholar
  12. 12.
    Siddiqui SH, Guasconi A, Vestbo J et al. Blood Eosinophils: A Biomarker of Response to Extrafine Beclomethasone/Formoterol in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2015;192(4):523–5CrossRefGoogle Scholar
  13. 13.
    Casanova C, Celli BR, de-Torres JP et al. Prevalence of persistent blood eosinophilia: relation to outcomes in patients with COPD. Eur Respir J. 2017;50(5).  https://doi.org/10.1183/13993003.01162-2017CrossRefGoogle Scholar
  14. 14.
    Hastie AT, Martinez FJ, Curtis JL et al. Association of sputum and blood eosinophil concentrations with clinical measures of COPDseverity: an analysis of the SPIROMICS cohort. Lancet Respir Med. 2017;5(12):956–67CrossRefGoogle Scholar
  15. 15.
    Yun JH, Lamb A, Chase R et al. Blood eosinophil count thresholds and exacerbations in patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol. 2018;141(6):2037–47.e10CrossRefGoogle Scholar
  16. 16.
    Singh D, Agusti A, Anzueto A et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive LungDisease: the GOLD science committee report 2019. Eur Respir J. 2019;53(5).  https://doi.org/10.1183/13993003.00164-2019CrossRefGoogle Scholar
  17. 17.
    Barnes PJ. Corticosteroid effects on cell signalling. Eur Respir J. 2006;27(2):413–26CrossRefGoogle Scholar
  18. 18.
    Oba Y, Keeney E, Ghatehorde N, Dias S. Dual combination therapy versus long-acting bronchodilators alone for chronic obstructivepulmonary disease (COPD): a systematic review and network meta-analysis. Cochrane Database Syst Rev. 2018;12:CD012620.  https://doi.org/10.1002/14651858.CD012620.pub2PubMedGoogle Scholar
  19. 19.
    Crim C, Calverley PM, Anderson JA et al. Pneumonia risk in COPD patients receiving inhaled corticosteroids alone or in combination: TORCH study results. Eur Respir J. 2009;34(3):641–7CrossRefGoogle Scholar
  20. 20.
    Janson C, Larsson K, Lisspers KH et al. Pneumonia and pneumonia related mortality in patients with COPD treated with fixedcombinations of inhaled corticosteroid and long acting β2 agonist: observational matchedcohort study (PATHOS). BMJ. 2013;346:f3306. Erratum in: BMJ. 2013;346:f4375CrossRefGoogle Scholar
  21. 21.
    Rachelefsky GS, Liao Y, Faruqi R. Impact of inhaled corticosteroid-induced oropharyngeal adverse events: results from a meta-analysis. Ann Allergy Asthma Immunol. 2007;98(3):225–38CrossRefGoogle Scholar
  22. 22.
    Chapman KR, Hurst JR, Frent SM et al. Long-Term Triple Therapy De-escalation to Indacaterol/Glycopyrronium in Patients with Chronic Obstructive Pulmonary Disease (SUNSET): A Randomized, Double-Blind, Triple-Dummy Clinical Trial. Am J Respir Crit Care Med. 2018;198(3):329–39CrossRefGoogle Scholar
  23. 23.
    Magnussen H, Disse B, Rodriguez-Roisin R et al. Withdrawal of inhaled glucocorticoids and exacerbations of COPD. N Engl J Med. 2014;371(14):1285–94CrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • Johannes Krönig
    • 1
    Email author
  • Andreas Klemmer
    • 1
  • Claus F. Vogelmeier
    • 1
  1. 1.Klinik für PneumologieUniversitätsklinikum MarburgMarburgDeutschland

Personalised recommendations