Preview

Vestnik SurGU. Meditsina

Advanced search

RISK FACTORS OF DRUG LOAD INCREASE FOR PEDIATRIC PATIENTS WITH BRONCHIAL ASTHMA (TEN-YEAR PROSPECTIVE MONITORING RESULTS)

https://doi.org/10.35266/2304-9448-2023-2-45-51

Abstract

The study aims to determine the anamnestic, functional, and laboratory factors affecting the load of basic drug therapy in children with bronchial asthma during a ten-year regular dynamic monitoring of their height,
body weight, spirometry data, the nature of the ongoing treatment of asthma, and the drug doses. An open, prospective monitoring trial included 131 patients, each of whom attended a hospital at least 20 times every 6 months.
The data obtained was not used to correct the therapy method and regular medical check-up. By the end of the tenth year, 98 patients had demonstrated the following results: 57.1 % of children maintained a stable load of basic
therapy, while the load of drug therapy was increased in 24.5 % of patients, and decreased in 18.4 % of them. The likelihood of a drug load reduction was statistically significantly reduced in patients with a body mass index greater than 90 weight percentile for 18 months or longer in comparison with patients who had never been overweight. Patients with the obstructive disorders detected with spirometry during two or more consecutive visits had
a statistically significantly higher risk of drug therapy overload or a lower likelihood of its reduction in comparison with those without any external respiration malfunctions. The allergen-specific therapy made it possible to significantly lower the risk of drug overload and increase the possibility of its reduction. The allergen-specific immunotherapy, body weight management, and absence of obstructive disorders in spirometry all contribute to reducing
the drug therapy load while maintaining a controlled course of the disease.

About the Authors

A. V. Kamaev
Academician I. P. Pavlov First St. Petersburg State Medical University, Saint Petersburg
Russian Federation

Candidate of Sciences (Medicine), Docent
E-mail: andykkam@mail.ru



Yu. L. Mizernitsky
Veltischev Research and Clinical Institute for Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University, Moscow
Russian Federation

Doctor of Sciences (Medicine), Professor
E-mail: yulmz@mail.ru



O. V. Trusova
Academician I. P. Pavlov First St. Petersburg State Medical University, Saint Petersburg
Russian Federation

Candidate of Sciences (Medicine), Docent
E-mail: o-tru@mail.ru



N. L. Shaporova
Academician I. P. Pavlov First St. Petersburg State Medical University, Saint Petersburg
Russian Federation

Doctor of Sciences (Medicine), Professor

E-mail: shapnl@mail.ru



References

1. Global strategy for asthma management and prevention. URL: https://ginasthma.org/wp-content/uploads/2022/07/GINA-Main-Report-2022 FINAL-22-07-01-WMS.pdf (дата обращения: 01.02.2023).

2. Бронхиальная астма. URL: https://cr.minzdrav.gov.ru/recomend/359 (дата обращения: 01.02.2023).

3. Бронхиальная астма у детей. Стратегия лечения и профилактика : нац. программа. 6-е изд., перераб. и доп. М. : МедКом-Про, 2021. 228 с.

4. Honkamäki J., Piirilä P., Hisinger-Mölkänen H. et al. Asthma remission by age at diagnosis and gender in a population-based study. J Allergy Clin Immunol Pract. 2021;9(5):1950–1959.e4.

5. Павленко В. А., Мельникова И. М., Мизерницкий Ю. Л. Клинико диагностические аспекты прогноза бронхиальной астмы у детей раннего возраста // Медицинский совет. 2017. № 9. С. 70–75. DOI 10.21518/2079-701X-2017-9-70-75.

6. Kansen H. M., Le T. M., Uiterwaal C. et al. Prevalence and predictors of uncontrolled asthma in children referred for asthma and other atopic diseases. J Asthma Allergy. 2020;(13):67–75.

7. Геппе Н. А., Камаев А. В., Кондюрина Е. Г. и др. Подростковый возраст у пациента с тяжелым течением бронхиальной астмы: известные риски и новые возможности контроля // Вопросы практической педиатрии. 2019. Т. 14, № 6. С. 63–71. DOI 10.20953/1817-7646-2019-6-63-71.

8. Miller R. L., Grayson M. H., Strothman K. Advances in asthma: New understandings of asthma’s natural history, risk factors, underlying mechanisms, and clinical management. J Allergy Clin Immunol. 2021;148(6):1430–1441.

9. Мизерницкий Ю. Л. Бронхиальная астма у детей // Избранные вопросы педиатрии / под ред. И. Н. Захаровой. М. : Ре Медиа, 2020. C. 179–208.

10. Alvaro-Lozano M., Akdis C. A., Akdis M. et al. EAACI allergen immunotherapy user’s guide. Pediatr Allergy Immunol. 2020;31(25):1–101.

11. Трусова О. В., Камаев А. В., Гайдук И. М. и др. Эволюция бронхиальной астмы у детей в течение трех лет от постановки диагноза // Медицинский совет. 2022. № 12. С. 178–185.

12. De Onis M., Onyango A. W., Borghi E. et al. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85(9):660–667.

13. Papadopoulos N. G., Čustović A., Cabana M. D. et al. Pediatric asthma: An unmet need for more effective, focused treatments. Pediatr Allergy Immunol. 2019;30(1):7–16.

14. Koefoed H. J. L., Zwitserloot A. M., Vonk J. M. et al. Asthma, bronchial hyperresponsiveness, allergy and lung function development until early adulthood: A systematic literature review. Pediatr Allergy Immunol. 2021;32(6):1238–1254.

15. Подкорытов А. А., Мещеряков В. В., Кирсанов В. В. Современные методы контроля и мониторинга бронхиальной астмы у детей // Вестник СурГУ. Медицина. 2021. № 4. С. 17–25.

16. Дубровская И. В., Кузнецова Т. А. Анализ показателя индекса массы тела и относительного содержания жировой массы в диагностике коморбидного ожирения у детей с бронхиальной астмой // Вестник СурГУ. Медицина. 2020. № 3. С. 26–30.

17. Schmitt J., Wüstenberg E., Küster D. et al. The moderating role of allergy immunotherapy in asthma progression: Results of a populationbased cohort study. Allergy. 2020;75(3):596–602.

18. Хавкин А. И., Новикова В. П., Маталыгина О. А. и др. Аллергия и ожирение: выявление общих звеньев патогенеза как основа стратегии адекватной терапии // Вопросы практической педиатрии. 2022. Т. 17, № 4. С. 59–66. DOI 10.20953/1817-7646-2022-4-59-66.


Review

For citations:


Kamaev A.V., Mizernitsky Yu.L., Trusova O.V., Shaporova N.L. RISK FACTORS OF DRUG LOAD INCREASE FOR PEDIATRIC PATIENTS WITH BRONCHIAL ASTHMA (TEN-YEAR PROSPECTIVE MONITORING RESULTS). Vestnik SurGU. Meditsina. 2023;16(2):45-51. (In Russ.) https://doi.org/10.35266/2304-9448-2023-2-45-51

Views: 116


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2949-3447 (Online)