راهنمای رسیدگی بالینی در بیماران با آسم شدید: توافق مجربین متخصصین ریه ایران

انصارین, خلیل and عطاران, داود and جماعتی, حمیدرضا and مسجدی, محمد رضا and ابطحی, حمیدرضا and علوی, علی and علیاری, مسعود and اثنی عشری, امیر and قبادی مراللو, حسن and ترابی نامی, محمد (1394) راهنمای رسیدگی بالینی در بیماران با آسم شدید: توافق مجربین متخصصین ریه ایران. Tanaffos ــ 14 (2). pp. 73-94. شاپا 0344-1735


Official URL: http://www.tanaffosjournal.ir


Approach to Patients with Severe Asthma: a Consensus Statement from the Respiratory Care Experts’ Input Forum(RC-EIF), Iran

English Abstract

Challenges in the assessment, diagnosis and management of severe, difficult-to-control asthma are increasingly regarded as clinical needs yet unmet. The assessments required to determine asthma severity, comorbidities and confounding factors, disease phenotypes and optimal treatment are among the controversial issues in the field. The respiratory care experts’ input forum (RC-EIF), comprised of an Iranian panel of experts, reviewed the definition, appraised the available guidelines and provided a consensus for evaluation and treatment of severe asthma in adults. A systematic literature review followed by discussions during and after the forum, yielded the present consensus. The expert panel used the appraisal of guidelines for research and evaluation-II (AGREE-II) protocol to define an initial locally-adapted strategy for the management of severe asthma. Severe asthma is considered a heterogeneous condition with various phenotypes. Issues such as assessment of difficult-tocontrol asthma, phenotyping, the use of blood and sputum eosinophil count, exhaled nitric oxide to guide therapy, the position of anti-IgE antibody, methotrexate, macrolide antibiotics, antifungal agents and bronchial thermoplasty as well as the use of established, recently-developed and evolving treatment approaches were discussed and unanimously agreed upon in the panel. A systematic approach is required to ensure proper diagnosis, evaluate compliance, and to identify comorbidities and triggering factors in severe asthma. Phenotyping helps select optimized treatment. The treatment approach laid down by the Global Initiative for Asthma (GINA) needs to be followed, while the benefit of using biological therapies should be weighed against the cost and safety concerns.

Item Type:Article
زبان سند : انگلیسی
نویسنده اول :خلیل انصارین
سایر :داود عطاران
سایر :حمیدرضا جماعتی
سایر :محمد رضا مسجدی
سایر :حمیدرضا ابطحی
سایر :علی علوی
سایر :مسعود علیاری
سایر :امیر اثنی عشری
نویسنده :حسن قبادی مراللو
نویسنده مسئول :محمد ترابی نامی
Additional Information:Indexed in: Pubmed/PMC, Scoups, Embase, Ebsco, Index copernicus, DOAJ, SID, ISC, Google Scholar, Magiran
کلیدواژه ها (انگلیسی):Severe asthma, Definition, Comorbidities, Treatment, Phenotyping, Consensus statement, Iran
Subjects:WB Practice of Medicine
WF Respiratory System
WT Geriatrics . Chronic Diseases
Divisions:Faculty of Medicine > Department of Internal Medicine , Cardiology , Infectious
ID Code:6985
Deposited By: Dr Hassan Ghobadi
Deposited On:26 Jul 1394 07:09
Last Modified:11 Apr 1399 10:59

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