軽症持続型気管支喘息における吸入ステロイド療法の批判的吟味

概要

論文の詳細を見る
Although current guidelines recommend regularly scheduled administration of inhaled corticosteroids for patients with mild persistent asthma, medication records suggest that most patients only use such controller therapy intermittently. While the START (inhaled steroid treatment as regular therapy in early asthma) study found that daily treatment with inhaled corticosteroids decreased the risk of severe exacerbation and improved asthma control in patients with mild persistent asthma, the IMPACT (Improving Asthma Control) study found that intermittent treatment with inhaled steroids had about the same rates of severe exacerbation and asthma-related lung function decline as those on the recommended standard daily controller medication. To determine whether these findings were valid and representative, we critically appraised the START study and the IMPACT study according to CONSORT. The START study was generally of high methodological quality but the IMPACT study had some weaknesses in study design, clinically relevant outcomes, and participant flow. Accordingly, most patients with mild persistent asthma should be recommended to follow daily treatment with inhaled corticosteroids. The intermittent-treatment approach would be feasible for patients with a long history of mild persistent asthma who have good adherence to medication regimens.
日本医療薬学会の論文
2005-11-10