Bronchial asthma therapy in real clinical practice and factors affecting its efficacy

Sidorenko E.V., Vykhristenko L.R., Ogrizko S.V., Zakharova O.V.

Vitebsk state medical University, Vitebsk , Belarus

The purpose of the study is to evaluate the effectiveness of bronchial asthma therapy and factors affecting its course in actual clinical practice.
Materials and methods. 153 patients of the allergological department of the Vitebsk regional clinical hospital with atopic and non-atopic asthma aged 18 to 60 years who received standard pharmacotherapy according to examination and treatment protocols were examined. Of these, 86 patients were with allergic BA (48 women, 38 men) aged 37.5 (18- 59) years (group 1) and 67 patients with mixed (allergic and non-allergic) BA (34 women, 14 men) aged 44.5 (21-60)years (group 2). All patients underwent comprehensive monitoring of the condition, assessing the level of control of asthma symptoms (AST test), quality of life (AQ-20), the need for β2-agonists and inhaled glucocorticosteroids, the frequency of exacerbations during the year. Considered the presence of burdened heredity for allergic diseases, duration of the disease, polysensitization, concomitant allergic rhinitis, comorbid pathology (GERD, obesity, COPD, etc.). The impact of allergen-specific therapy on the course of asthma after its cancellation for 2 years has been evaluated.
Results. It was found that in all patients with asthma the BA control level was reduced according to the AST-test questionnaire, the subjective assessment of the quality of life was reduced according to the AQ-20 questionnaire. A larger number of patients with mixed BA are used in the treatment of β2-agonists and inhaled glucocorticosteroids. The need for β2-agonists and inhaled glucocorticosteroids per year was higher in patients with mixed bronchial asthma, as was the number of patients using them (p <0.05).
Findings. The data obtained confirm the heterogeneity of bronchial asthma. In each case, it is necessary to analyze the factors that can adversely affect the course of bronchial asthma (clinical phenotype, experience of the disease, the presence of polysensitivity, comorbid pathology) and factors that increase the effectiveness of treatment (early diagnosis of asthma, treatment commitment, allergen-specific immunotherapy). Treatment in accordance with currently used recommendations, despite the phased approach, is unified, and requires more to take into account the individual characteristics of the patient.