Section 3. a discussion of flexible dosing and patient-centered therapy Highlights of the asthma summit 2009 beyond the guidelines 英文参考文献.docVIP

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Section 3. a discussion of flexible dosing and patient-centered therapy Highlights of the asthma summit 2009 beyond the guidelines 英文参考文献.doc

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Section 3. a discussion of flexible dosing and patient-centered therapy Highlights of the asthma summit 2009 beyond the guidelines 英文参考文献

CONFERENCEPROCEEDINGS Section3.ADiscussionofFlexibleDosingand Patient-CenteredTherapy HighlightsoftheAsthmaSummit2009:BeyondtheGuidelines G.WalterCanonica,MD,1 andChristopherBrightling,MD2 trolled despite the bene?ts of treatment demonstrated in Abstract: Despite positive clinical experience and the published clinical trials. Therefore, there is a substantial unmet need. clinicalbene?tsofmonotherapywithlow-ormedium-doseinhaled Within this group some patients will have severe asthma, corticosteroids or combination therapy with ICS ? long-acting whichmaybe‘dif?cult-to-treat’or‘refractory’tohighdoses beta-agonist to treat asthma, many patients remain suboptimally of ICS or even oral corticosteroids with or without other controlled. Alternative approaches are needed, and 3 options that medications. This group presents a clinical challenge and have had some success are: 1) using the patient’s level of in?am- needstobemanagedbyanasthmaspecialist.Controlcanbe mationbyestablishedbiomarkerstosettreatment;2)self-manage- regained in some using alternative strategies. Recognizing mentincorporating?exibledosing;and3)usingasingleinhalerfor this, the question is: “What can we do to improve asthma rescueandmaintenancetherapy.Whichstrategyforwhichpatient controlforthesestep2andstep3patients.” dependsultimatelyontheindividualpatient’sdiseaseburden,life- Alternative approaches are, thus, needed to improve style, comorbidities, preferences, and his or her ability to self- asthma control. Three options that have had some success manage the disease, including assessing symptoms and adhering withtherapy. willbereviewedbrie?y:1)treatingpatientsaccordingtotheir levelofin?ammationasdemonstratedbyestablishedbiomar- kers;2)?exibledosingforpatientself-management;and3) usingasingleinhaler. KeyWords:asthma,inhaledcorticosteroid,?exibledosing, combinationtherapy,long-actingbeta-agonist (WAOJournal2010;3:31–37) TREATINGPATIENTSACCORDINGTOTHEIR LEVELOFINFLAMMATION C Acontrolledstudycomparedpatie