{"title":"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","authors":"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","doi":"10.12932/AP-190824-1910","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>To review the literature and develop Delphi consensus statements on the use of nebulized ICS for the management of asthma and COPD in adults.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>Nebulized budesonide is an effective and well tolerated treatment option for the management of asthma and COPD.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A Delphi consensus on nebulized budesonide for adults with asthma and COPD.\",\"authors\":\"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\",\"doi\":\"10.12932/AP-190824-1910\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>To review the literature and develop Delphi consensus statements on the use of nebulized ICS for the management of asthma and COPD in adults.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>Nebulized budesonide is an effective and well tolerated treatment option for the management of asthma and COPD.</p>\",\"PeriodicalId\":8552,\"journal\":{\"name\":\"Asian Pacific journal of allergy and immunology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-06-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asian Pacific journal of allergy and immunology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.12932/AP-190824-1910\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Pacific journal of allergy and immunology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.12932/AP-190824-1910","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ALLERGY","Score":null,"Total":0}
A Delphi consensus on nebulized budesonide for adults with asthma and COPD.
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.
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.
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