A Delphi consensus on nebulized budesonide for adults with asthma and COPD.

IF 2.3 4区医学 Q3 ALLERGY

Asian Pacific journal of allergy and immunology Pub Date : 2025-06-03 DOI:10.12932/AP-190824-1910

Phunsup Wongsurakiat, Akrawat Rattanawongpaibul, Atikun Limsukon, Chirawat Chiewchalermsri, Kittipong Maneechotesuwan, Kittiyaporn Wiwatcharagoses, Kumpol Kornthatchapong, Narongkorn Saiphoklang, Pitsucha Sanguanwit, Pornanan Domthong, Tirachat Sewatanon, Wipa Reechaipichitkul, Theerasuk Kawamatawong

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引用次数: 0

Abstract

Background: Inhaled corticosteroids (ICS) represent an alternative treatment option to systemic corticosteroids (SCS) in the treatment of asthma and chronic obstructive pulmonary disease (COPD); however, detailed clinical guidance on the use of nebulized ICS, such as budesonide, in the management of asthma and COPD remains scarce.

Objective: To review the literature and develop Delphi consensus statements on the use of nebulized ICS for the management of asthma and COPD in adults.

Methods: An expert panel of 13 respiratory physicians, comprising pulmonologists (n = 9), allergists (n = 1), and emergency department consultants (n = 3) from tertiary medical centers in Thailand, undertook a Delphi procedure with the aim of developing evidence-based consensus statements on the use of nebulized ICS in patients with asthma and COPD. Panelists used a 5-point Likert scale to score their agreement with each statement.

Results: A total of 12 Delphi consensus statements pertaining to the use of nebulized ICS in the management of asthma and COPD in both acute and maintenance care were developed. The overall consensus of the panel across the 12 statements was very high (mean agreement score, 4.2-4.9/5). The panelists expressed strongest consensus agreement (84.6% strong agreement) with the following two statements: 1) inhalation devices are the cornerstone of drug delivery in patients with asthma and COPD, and 2) for adult asthma and COPD patients with severe exacerbations, nebulization is more suitable for drug delivery than a pMDI plus spacer.

Conclusions: Nebulized budesonide is an effective and well tolerated treatment option for the management of asthma and COPD.

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布地奈德雾化治疗成人哮喘和慢性阻塞性肺病的德尔菲共识

背景：在哮喘和慢性阻塞性肺疾病（COPD）的治疗中，吸入糖皮质激素（ICS）是全身糖皮质激素（SCS）的替代治疗选择；然而，关于雾化ICS（如布地奈德）在哮喘和慢性阻塞性肺病治疗中的使用的详细临床指南仍然很少。目的：回顾文献并建立德尔菲共识声明雾化ICS用于治疗成人哮喘和COPD。方法：一个由13名呼吸内科医生组成的专家小组，包括来自泰国三级医疗中心的肺科医生（n = 9）、过敏症专家（n = 1）和急诊科顾问（n = 3），进行了德尔菲程序，目的是就雾化ICS在哮喘和COPD患者中的使用达成循证共识声明。小组成员使用5分李克特量表对他们对每个陈述的同意程度进行评分。结果：共有12个德尔菲共识声明，涉及雾化ICS在哮喘和慢性阻塞性肺病的急性和维持护理中的使用。专家组对12项陈述的总体共识非常高（平均同意分，4.2-4.9/5）。专家组成员对以下两点表达了最强烈的共识（84.6%的强烈同意）：1)吸入装置是哮喘和COPD患者给药的基石，2)对于严重加重的成人哮喘和COPD患者，雾化比pMDI加间隔剂更适合给药。结论：布地奈德雾化治疗哮喘和慢性阻塞性肺病是一种有效且耐受性良好的治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asian Pacific journal of allergy and immunology 医学-过敏

CiteScore

12.80

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： The Asian Pacific Journal of Allergy and Immunology (APJAI) is an online open access journal with the recent impact factor (2018) 1.747 APJAI published 4 times per annum (March, June, September, December). Four issues constitute one volume. APJAI publishes original research articles of basic science, clinical science and reviews on various aspects of allergy and immunology. This journal is an official journal of and published by the Allergy, Asthma and Immunology Association, Thailand. The scopes include mechanism, pathogenesis, host-pathogen interaction, host-environment interaction, allergic diseases, immune-mediated diseases, epidemiology, diagnosis, treatment and prevention, immunotherapy, and vaccine. All papers are published in English and are refereed to international standards.