Nebulizer therapy for lung diseases

The article presents data on the use of nebulizer therapy for major respiratory diseases: chronic obstructive pulmonary disease (COPD), bronchial asthma. The conditions for using aerosol-producing devices for new COVID-19 coronavirus infection, in the hospital and at home are also given. Historical aspects of the creation and use of devices for nebulizer therapy are considered. A differentiated approach is given when choosing an inhaler depending on the clinical situation, taking into account the need to use devices with a high level of precipitated fine particle fraction of the pharmaceutical aerosol, external minimal losses, with a reduced inhalation time and an economical treatment regime with optimal medication consumption. These advantages are inherent to nebulizers of the company PARI: PARI BOY SX and VELOX®. In patients with COPD, options for using nebulizer therapy in a stable state and in exacerbation are considered. It is emphasized that the inhaled route of administration of drugs provides direct penetration of the drug into the respiratory tract and, thus, contributes to a more effective drug effect. In addition, the inhalation route of administration reduces the potential risk of side effects. In patients with bronchial asthma, priority is given to the appointment of inhaled corticosteroids and β2-agonists in exacerbation. Data on the main types of devices, their advantages and disadvantages are provided. In conclusion, it is concluded that nebulizer therapy is a modern way to deliver the drug to the respiratory tract. In a number of clinical situations, the use of nebulizers is the only way to deliver the drug to a pathological focus. The use of nebulizers significantly expands the treatment options for patients with COPD and BA, reduces the need for hospitalization, and prevents the development of severe exacerbations. © 2020, Remedium Group Ltd. All rights reserved

Severe bronchial asthma patient care organization in various regions of the Russian Federation. From endotypes and phenotypes of bronchial asthma to personalized choice of therapy

© 2020 Consilium Medikum. All rights reserved. The meeting of the Expert board was held in Moscow on June 24, 2019, at which the following issues were considered: the applicability of a new terminology characterizing asthma endotypes and phenotypes in real clinical practice, the effect of phenotypes and biomarkers in patients with bronchial asthma on the choice of biological drug, as well as the optimal clinical profiles of patients for whom dupilumab is most effective, taking into account the data of the III phase clinical trials, regional features of medical care and changes in updated international clinical guidelines for the diagnosis and treatment of asthma. The Expert board included members of leading Russian scientific and educational medical institutions: S.N. Avdeev, corresponding member of the Russian Academy of Sciences, prof., MD; O.A. Volkova, Ph.D.; I.V. Demko, prof., MD; G.L. Ignatova, prof., MD; I.V. Leshchenko, prof., MD; Kanukova N.A.; Kudelya L.M., prof., MD; V.A. Nevzorova, prof., MD; N.G. Nedashkovskaya; O.P. Ukhanova, prof., MD; L.V. Shulzhenko, prof., MD; R.S. Fassakhov, prof., MD

Вакцинопрофилактика пневмококковых инфекций у взрослых. Резолюция совета экспертов (Москва, 16 декабря 2017 г.)

The following key issues of pneumococcal infection prophylaxis were discussed during the expert council: incidence rates of community-acquired pneumococcal pneumonia and other pneumococcal infections, local epidemiological data, increases in antimicrobial resistance and pneumococcal serotypes substitution, current international and Russian clinical guidelines, practical approaches, and pneumococcal vaccination coverage of adult population in the Russian Federation. The agreement between the experts about a need to distinguish the use of conjugate vaccines and polysaccharide vaccines in different subpopulations has been achieved.В ходе совета экспертов обсуждены ключевые вопросы профилактики пневмококковой инфекции (ПИ): ситуация с заболеваемостью внебольничной пневмококковой пневмонией (ВП) и другими ПИ, особенности локальной эпидемиологии, роста резистентности и замещения штаммов пневмококка, существующие международные и российские клинические рекомендации, текущие практические подходы, охват вакцинацией взрослого населения РФ. Сформулировано консолидированное мнение о необходимости разграничения использования конъюгированных и полисахаридных вакцин в разных группах населения

The concept of chronic obstructive pulmonary disease clinical control as a decision-making tool in real clinical practice for optimizing of basic pharmacotherapy [Концепция контроля хронической обструктивной болезни легких как инструмент принятия решения и оптимизации базисной терапии в реальной клинической практике]

The main goals of COPD therapy are to achieve clinical stability with minimal clinical manifestations and low risk of relapse. The proposed COPD control concept by analogy with asthma has not been quite well characterized yet. COPD control is defined as "the long-term maintenance of a clinical situation with a low impact of symptoms on the patient's life and absence of exacerbations." The situation of clinical control in COPD is considered desirable and potentially achievable for most patients with COPD. Pharmacotherapeutic options for COPD are constantly expanding. The control concept may be useful when the decision on treatment of COPD is made for dynamic adjustment of the therapy volume. © 2020 Consilium Medikum. All rights reserved

Концепция контроля хронической обструктивной болезни легких как инструмент принятия решения и оптимизации базисной терапии в реальной клинической практике

The main goals of COPD therapy are to achieve clinical stability with minimal clinical manifestations and low risk of relapse. The proposed COPD control concept by analogy with asthma has not been quite well characterized yet. COPD control is defined as "the long - term maintenance of a clinical situation with a low impact of symptoms on the patient’s life and absence of exacerbations." The situation of clinical control in COPD is considered desirable and potentially achievable for most patients with COPD. Pharmacotherapeutic options for COPD are constantly expanding. The control concept may be useful when the decision on treatment of COPD is made for dynamic adjustment of the therapy volume.Основными целями терапии хронической обструктивной болезни легких (ХОБЛ) является достижение клинической стабильности с наименьшим количеством симптомов и низким риском обострений. Предложенная концепция контроля ХОБЛ по аналогии с бронхиальной астмой пока недостаточно хорошо охарактеризована. Контроль ХОБЛ определяется как «долгосрочное поддержание клинической ситуации с низким воздействием симптомов на жизнь пациента и отсутствием обострений». Ситуация клинического контроля при ХОБЛ рассматривается как желательная и потенциально достижимая для большинства пациентов с ХОБЛ. Возможности фармакологической терапии ХОБЛ постоянно расширяются. Концепция контроля может быть полезна для принятия решения о лечении ХОБЛ для динамической корректировки объема терапии

Вакцинопрофилактика пневмококковых инфекций у взрослых. Резолюция совета экспертов (Москва, 16 декабря 2017 г.)

The following key issues of pneumococcal infection prophylaxis were discussed during the expert council: incidence rates of community-acquired pneumococcal pneumonia and other pneumococcal infections, local epidemiological data, increases in antimicrobial resistance and pneumococcal serotypes substitution, current international and Russian clinical guidelines, practical approaches, and pneumococcal vaccination coverage of adult population in the Russian Federation. The agreement between the experts about a need to distinguish the use of conjugate vaccines and polysaccharide vaccines in different subpopulations has been achieved.В ходе совета экспертов обсуждены ключевые вопросы профилактики пневмококковой инфекции (ПИ): ситуация с заболеваемостью внебольничной пневмококковой пневмонией (ВП) и другими ПИ, особенности локальной эпидемиологии, роста резистентности и замещения штаммов пневмококка, существующие международные и российские клинические рекомендации, текущие практические подходы, охват вакцинацией взрослого населения РФ. Сформулировано консолидированное мнение о необходимости разграничения использования конъюгированных и полисахаридных вакцин в разных группах населения

Practical recommendations for choosing an immunobiological preparation for the treatment of severe bronchial asthma of T2-endotype

© 2020 Medical Education. All rights reserved. Biological therapy of bronchial asthma (BA) is a modern method of treating severe forms of the disease, that are uncontrolled by traditional pharmacotherapeutic approaches. Currently, 5 monoclonal antibody (AT) preparations are registered in the world for the treatment of severe bronchial asthma (SBA) of the T2 endotype (T2-SBA) - antibodies, binding to immunoglobulin (Ig) E (anti-IgE - omalizumab), interleukin antagonists (IL)-5 (anti-IL-5 - mepolizumab, resizumab) and its receptor (anti-IL-5Rα - benralizumab), as well as antibodies, that selectively bind to the IL-4 and -13 receptor (anti-IL-4 /13Rα - dupilumab). The article presents data on the effectiveness of these drugs in relation to the key characteristics of SBA, formulates clinical and laboratory criteria, the study of which in real practice can potentially predict the likelihood of a clinical response to a particular type of biological therapy. An algorithm is proposed for choosing a targeted therapy strategy for patients with SBA, clinically associated with allergies, for patients with severe non-allergic eosinophilic BA and for patients with eosinophilic BA of a combined phenotype

New national and regional bryophyte records, 55

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