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1.
Allergol. immunopatol ; 51(4): 151-157, 2023. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-222645

RESUMO

Background and aim: Bronchial asthma is a prevalent type of respiratory disease that affects a large proportion of pediatric patients. The purpose of this study is to further investigate the clinical effects of budesonide combined with montelukast sodium in treating bronchial asthma. Methods: Eighty-six children with bronchial asthma were equally divided into study and control groups via randomized double-blind controlled trial. The control group was treated with aerosol inhalation of budesonide combined with placebo, while the study group was treated with budesonide combined with montelukast sodium. Pulmonary function parameters, immunoglobulin, and recovery of related symptoms, along with the adverse reaction rate, were observed and compared between both groups. Results: Before treatment, there was no marked difference in pulmonary function parameters and immunoglobulin indexes between both groups (P > 0.05). All pulmonary function indicators and immunoglobulin indexes in both groups improved following therapy, with the study group outperforming the control group (P < 0.05). The recovery time of related symptoms in the study group was shorter than that in the control group (P < 0.05). The incidence of adverse reactions in both groups was compared, with notable differences (P < 0.05). Conclusion: Budesonide combined with montelukast sodium in the treatment of bronchial asthma has the value of clinical application and promotion (AU)


Assuntos
Humanos , Pré-Escolar , Criança , Budesonida/administração & dosagem , Broncodilatadores/administração & dosagem , Asma/tratamento farmacológico , Imunoglobulinas/sangue , Antiasmáticos/administração & dosagem , Antagonistas de Leucotrienos/administração & dosagem , Citocromo P-450 CYP1A2/administração & dosagem , Quimioterapia Combinada , Resultado do Tratamento
2.
Allergol. immunopatol ; 51(4): 182-188, 2023. tab
Artigo em Inglês | IBECS | ID: ibc-222649

RESUMO

Objective: To evaluate the clinical efficacy and safety of combining omalizumab with budesonide formoterol to treat children with moderate and severe allergic asthma, and investigate the effect of this combination therapy on pulmonary and immune functions. Methods: The data of 88 children with moderate and severe allergic asthma, who were admitted to our hospital between July 2021 and July 2022, were included in the study. The patients were randomly assigned either to control group (n = 44; received budesonide formoterol inhalation therapy) or experimental group (n = 44; received omalizumab subcutaneous injection + budesonide formoterol inhalation therapy) using computer-generated randomization. The clinical efficacy, asthma control (measured using childhood Asthma-Control Test [C-ACT] score), pulmonary function (forced expiratory volume in 1 s, forced vital capacity, and peak expiratory flow), immune function (cluster of differentiation 3 cells [CD3+ cells], cluster of differentiation 4 cells [CD4+ cells], immunoglobulin G, immunoglobulin A, and immunoglobulin E), and adverse reactions were observed and compared between both groups. Results: After treatment, the experimental group had improved levels of pulmonary function and immune function indexes, higher C-ACT scores, and a higher overall response rate than the control group (P < 0.05). In addition, the incidence of adverse reactions was not significantly different between both groups (P > 0.05). Conclusion: The combination of omalizumab with budesonide formoterol for treating moderate and severe allergic asthma in children demonstrated promising clinical efficacy and improved their pulmonary and immune functions, leading to more rational asthma control. The combined regimen demonstrated satisfactory clinical safety and deserved clinical promotion (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Omalizumab/administração & dosagem , Antiasmáticos/administração & dosagem , Budesonida/administração & dosagem , Broncodilatadores/administração & dosagem , Asma/tratamento farmacológico , Índice de Gravidade de Doença , Resultado do Tratamento , Quimioterapia Combinada
3.
Sanid. mil ; 78(3): 182-187, septiembre 2022.
Artigo em Espanhol | IBECS | ID: ibc-214640

RESUMO

Se reseñan los medicamentos evaluados y con dictamen positivo por comisión de expertos de la Agencia Española de Medicamentos y Productos Sanitarios o de la Agencia Europea del Medicamento hechos públicos de abril a junio 2022, y considerados de mayor interés para el profesional sanitario. Se trata de opiniones técnicas positivas que son previas a la autorización y puesta en el mercado del medicamento. (AU)


The drugs assessed by the Spanish Agency for Medicines and Health Products or European Medicines Agency made public from April to June of 2022, and considered of interest to the healthcare professional, are reviewed. These are positive technical reports prior to the authorization and placing on the market of the product. (AU)


Assuntos
Humanos , Preparações Farmacêuticas , Equipamentos e Provisões , Budesonida
4.
Gastroenterol. hepatol. (Ed. impr.) ; 45(7): 561-570, Ago - Sep 2022. tab
Artigo em Inglês | IBECS | ID: ibc-206918

RESUMO

Budesonide is a glucocorticoid characterized by its local action, with a low systemic bioavailability. Since the original trial comparing budesonide with prednisone in 2010, it is recommended as an effective alternative for the treatment of non-severe acute or chronic autoimmune hepatitis. In this document, we review the general pharmacologic properties of glucocorticoids, the available evidence for the use of budesonide as first line option for autoimmune hepatitis as well as the safety profile of the drug.(AU)


La budesonida es un glucocorticoide que se caracteriza por su acción local, con una baja biodisponibilidad sistémica. Desde el ensayo original publicado en 2010, en el que se comparó la budesonida con prednisona, se recomienda como una alternativa eficaz en el tratamiento de los pacientes con hepatitis autoinmune aguda o crónica no grave. En este documento, revisamos las propiedades farmacológicas generales de los glucocorticoides, la evidencia disponible para el uso de budesonida como fármaco de primera línea en estos pacientes, así como el perfil de seguridad del fármaco.(AU)


Assuntos
Budesonida , Hepatite Autoimune/terapia , Hepatite Autoimune/tratamento farmacológico , Glucocorticoides , Prednisona , Gastroenterologia , Enteropatias
5.
Gastroenterol. hepatol. (Ed. impr.) ; 44(10): 671-679, Dic. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-222068

RESUMO

Objetivo: Estudiar las características epidemiológicas, clínicas y la respuesta al tratamiento en pacientes con colitis microscópica. Pacientes y método: Se recopilaron retrospectivamente los datos epidemiológicos, clínicos, analíticos y endoscópicos de 113 pacientes con colitis microscópica. La respuesta al tratamiento se analizó en 104 de ellos. La eficacia y la recidiva tras la administración de budesonida se evaluaron mediante curvas de supervivencia (Kaplan-Meier). Resultados: El 78% de los pacientes fueron mujeres, con una edad media de 65 ± 16 años. En los fumadores, la edad media fue 10 años menor. Un 48% tenía alguna enfermedad inmunomediada concomitante. El 60% sufrió un único brote de la enfermedad. La presentación clínica fue similar en ambos subtipos, aunque los pacientes con colitis colágena tuvieron con mayor frecuencia un curso crónico (48 vs. 29%, p = 0,047). La tasa de remisión con budesonida fue del 93% (IC 95%: 82-98). La incidencia acumulada de recidiva, tras una mediana de seguimiento de 21 meses, fue del 39% (IC 95%: 26-54%): 19% al año, 32% a los dos años y 46% a los tres años de seguimiento. No hubo diferencias en la respuesta clínica a la budesonida en función del tabaquismo o del subtipo de colitis microscópica. Conclusiones: La colitis microscópica es más frecuente en mujeres de edad avanzada. El tabaco se asoció a una aparición más precoz de la enfermedad, aunque no influyó en la evolución clínica o en la respuesta al tratamiento. La mayoría (> 90%) de los pacientes tratados con budesonida alcanzaron la remisión, aunque casi la mitad recidivaron posteriormente.(AU)


Objective: To study the epidemiological and clinical characteristics, and response to treatment in patients with microscopic colitis. Patients and method: Epidemiological, clinical, blood test and endoscopic data were retrospectively collected from 113 patients with microscopic colitis. Response to treatment was analyzed in 104 of them. Efficacy and relapse after treatment with budesonide were assessed using survival curves (Kaplan-Meier). Results: 78% of the patients were women, with a mean age of 65 ± 16 years. In smokers, the mean age was 10 years younger. 48% of them had some concomitant autoimmune disease; 60% suffered a single outbreak of the disease. The clinical presentation was similar in both subtypes, although patients with collagenous colitis had a chronic course more frequently (48% vs. 29%, p = 0.047). The remission rate with budesonide was 93% (95% CI 82-98). The cumulative incidence of relapse, after a median follow-up of 21 months, was 39% (95% CI 26-54%): 19% at one year, 32% at two years, and 46% at three years of follow-up. There were no differences in clinical response to budesonide based on smoking habit or microscopic colitis subtype. Conclusions: Microscopic colitis is more frequent in elderly women. Smoking was associated with earlier onset of the disease, although it did not influence the clinical course or response to treatment. The majority (> 90%) of patients treated with budesonide achieved remission, although nearly half subsequently relapsed.(AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Colite Microscópica/tratamento farmacológico , Colite Microscópica/epidemiologia , Colite Linfocítica , Colite Colagenosa , Budesonida , Gastroenterologia , Gastroenteropatias , Estudos Retrospectivos , Doenças do Sistema Imunitário , Interpretação Estatística de Dados
6.
Gastroenterol. hepatol. (Ed. impr.) ; 44(4): 251-260, Abr. 2021. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-221164

RESUMO

Background: Swallowed topical steroids are a mainstay drug therapy for eosinophilic esophagitis (EoE), studies have demonstrated good histologic response, but with enormous discrepancy in clinical and endoscopic improvement. We conducted this meta-analysis to investigate the efficacy of topical steroids in EoE in histological, clinical and endoscopic improvement. Methods: Several databases were searched from inception to August 1, 2019 for randomized controlled trials (RCTs) comparing topical steroids with placebo for EoE in the short-term. The outcomes of interest mainly included basic characteristics of the studies, histologic, clinical, endoscopic response rate and adverse events. The results were pooled together using Reviewer Manager 5.3.5 software, and inconsistency was quantified using I2 statistics. Results: Nine studies were eventually selected. The results showed that topical steroids were effective in inducing histologic response compared with placebo for both complete (OR 35.82, 95% CI 14.98–85.64, P<0.0001; I2=0, P=0.72) and partial response (OR 28.44, 95% CI 8.56–94.47, P<0.0001; I2=70%, P=0.0009). Moreover, topical steroids were useful in gaining clinical response (OR 2.53, 95% CI 1.14–5.60, P=0.02; I2=60%, P=0.02) and endoscopic response (OR 3.51, 95% CI 1.47–8.36, P=0.005; I2=0, P=0.57). Generally, topical steroids are well tolerated. The most common adverse events are infections and infestations (59 cases). Conclusion: Topical steroids were effective in inducing histological, clinical and endoscopic response in the short-term, and the adverse events were almost tolerable; however, we should interpret the result of clinical and endoscopic response with caution.(AU)


Antecedentes: Los esteroides tópicos tragados son una terapia farmacológica principal de la esofagitis eosinofílica (EoE). Algunos estudios han demostrado una buena respuesta histológica, aunque con gran discrepancia en la mejora clínica y endoscópica. Hemos realizado este metaanálisis para investigar la eficacia de los esteroides tópicos en EoE en la mejora histológica, clínica y endoscópica. Métodos: Se buscaron varias bases de datos desde el inicio hasta el 1 de agosto de 2019 para ensayos controlados aleatorios comparando esteroides tópicos con placebo para EoE a corto plazo. Los resultados de interés incluyeron principalmente características básicas de los estudios, histológicas, clínicas, tasa de respuesta endoscópica y eventos adversos. Los resultados se agruparon mediante el software de Reviewer Manager 5.3.5, y la incoherencia se cuantificó mediante estadísticas I2. Resultados: Nueve estudios fueron finalmente seleccionados. Los resultados mostraron que los esteroides tópicos fueron eficaces en la inducción de la respuesta histológica en comparación con placebo tanto para la respuesta completa (OR 35,82; IC 95%: 14,98-85,64; p<0,0001; I2 0, p=0,72) como para la parcial (OR 28,44; IC 95%: 8,56-94,47; p<0,0001; I2 70%, p=0,0009). Los esteroides tópicos también fueron útiles en la obtención de respuesta clínica (OR 2,53; IC 95%: 1,14-5,60; p=0,02; I2 60%; p=0,02) y respuesta endoscópica (OR 3,51; IC 95%: 1,47-8,36; p=0,005; I2 0; p=0,57). Los esteroides tópicos suelen ser bien tolerados. Los acontecimientos adversos más frecuentes son infecciones e infestaciones (59 casos). Conclusión: Los esteroides tópicos fueron eficaces en la inducción de la respuesta histológica, clínica y endoscópica a corto plazo, y los eventos adversos fueron tolerables; sin embargo, debemos interpretar con precaución el resultado de la respuesta clínica y endoscópica.(AU)


Assuntos
Humanos , Masculino , Feminino , Esofagite Eosinofílica/patologia , Esofagite Eosinofílica/tratamento farmacológico , Esteroides , Administração Tópica , Resultado do Tratamento , Fluticasona , Budesonida , Esofagoscopia
8.
Gastroenterol. hepatol. (Ed. impr.) ; 43(2): 97-105, feb. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-188305

RESUMO

Aunque un elevado porcentaje de pacientes con colitis ulcerosa debería recibir tratamiento tópico por vía rectal, los estudios de práctica clínica han demostrado que este está infrautilizado. El propósito de este artículo es el de responder a 10 preguntas concretas sobre qué fármacos están disponibles para uso tópico, su forma de presentación, formulación y métodos de aplicación, así como cuál de ellos es más eficaz e idóneo en los distintos escenarios clínicos de la colitis ulcerosa. Asimismo, se evalúa la posibilidad de combinar diferentes formulaciones y vías de administración, y la utilidad en la fase de remisión de la enfermedad. Por último, se hacen una serie de recomendaciones para una mejor información de los pacientes acerca de una correcta aplicación y administración


Although most patients with ulcerative colitis should be given topical treatment, different studies have shown that they are underused in clinical practice. The purpose of this article is to answer 10 specific questions about which drugs are available for topical use in the treatment of ulcerative colitis, and their characteristics in terms of formulation, dosage, presentation, application and proximal distribution of rectal-administered drugs. The efficacy of available topical drugs and the benefits of combining different formulations and routes of administration, and their usefulness during disease remission are evaluated. Finally, a series of recommendations addressed to patients are given on the correct application of topical treatment


Assuntos
Humanos , Consenso , Colite Ulcerativa/terapia , Administração Tópica , Doença de Crohn/terapia , Resultado do Tratamento , Conferências de Consenso como Assunto , Espanha , Mesalamina/uso terapêutico , Budesonida/uso terapêutico , Triancinolona/uso terapêutico , Beclometasona/uso terapêutico , Hidrocortisona/uso terapêutico
9.
Rev. esp. enferm. dig ; 112(1): 53-58, ene. 2020. graf
Artigo em Espanhol | IBECS | ID: ibc-196009

RESUMO

La colitis microscópica es una causa frecuente de diarrea crónica acuosa, con gran repercusión sobre la calidad de vida de los pacientes y que engloba a su vez dos subtipos histológicos: la colitis colágena y la colitis linfocítica. El incremento de la incidencia y de la conciencia de esta enfermedad ha dado lugar a la publicación de varios documentos de consenso internaciones en los últimos años. A pesar de ello, el uso en la práctica clínica de tratamientos con escasa evidencia científica es frecuente y existe todavía una importante heterogeneidad en el manejo de estos pacientes. En este artículo se revisa el papel terapéutico de la budesonida en la colitis microscópica y se resume la evidencia actual acerca de otros tratamientos disponibles para esta enfermedad, especialmente para el manejo de pacientes refractarios. Finalmente, se propone un algoritmo actualizado de tratamiento


No disponible


Assuntos
Humanos , Medicina Baseada em Evidências , Colite Microscópica/tratamento farmacológico , Budesonida/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Glucocorticoides/uso terapêutico , Terapia Biológica , Mercaptopurina/uso terapêutico , Metotrexato/uso terapêutico , Prevenção Secundária , Indução de Remissão , Algoritmos
11.
J. investig. allergol. clin. immunol ; 30(1): 42-48, 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-194105

RESUMO

OBJECTIVE: Our aim was to evaluate the relationship between the clinical factors of asthma and the use of reliever medication. METHODS: We performed an observational cross-sectional study in Spain. The study population comprised patients aged ≥12 years diagnosed with persistent asthma according to the criteria of the Global Initiative for Asthma and receiving maintenance treatment for at least 12 months. Use of reliever medication was classified as low use of reliever medication (LURM) (≤2 times/wk) and high use of reliever medication (HURM) (≥3 times/wk). A variety of clinical variables and patient-reported outcomes (PROs) were recorded (eg, scores on the Asthma Control Questionnaire-5 [ACQ-5] and Test of Adherence to Inhalers [TAI]). RESULTS: A total of 406 patients were recruited. Mean (SD) age was 44.3 (17.9) years, and 64% were women. Reliever medication was used ≤2 times/wk in 76.1%. Bivariate analysis showed that HURM was related to smoking habit, unscheduled emergency department visits, hospital admissions, higher doses of inhaled corticosteroid, and night awakenings in the previous 4 weeks (P<.001). The multivariate analysis showed a higher risk of using reliever medication in smokers and former smokers, when the number of night awakenings increased, in cases of self-perception of partially controlled or uncontrolled asthma, or when asthma is uncontrolled according to the ACQ-5. CONCLUSIONS: Our study identifies the potential of poor use of reliever medication in the last week as an alarm signal for disease-related parameters such as exacerbations, poor asthma control, and disease severity


OBJETIVO: Nuestro objetivo fue evaluar la relación entre parámetros clínicos del asma y el uso de medicación de rescate. MÉTODOS: Estudio observacional de corte transversal realizado en España. El estudio reclutó pacientes ≥12 años diagnosticados con asma persistente según los criterios de GINA y que recibieron tratamiento de mantenimiento durante al menos 12 meses. El uso de la medicación de rescate fue dicotomizado: bajo uso de medicación de rescate (LURM) (≤dos veces/semana) o alto uso de medicación de rescate (HURM) (≥tres veces/semana). Se registraron una variedad de variables clínicas y resultados notificados por los pacientes (PRO), como el Cuestionario de Control del Asma-5 (ACQ-5) y la Prueba de Adherencia a Inhaladores (TAI). RESULTADOS: Se reclutaron 406 pacientes, de 44,3 [17,9] años edad media (DE) y un 64% de mujeres. En el 76,1% se utilizó medicación de rescate ≤dos veces por semana. El análisis bivariante mostró que la HURM estaba relacionada con el hábito de fumar, las visitas no programadas a urgencias, ingresos hospitalarios, aumento de las dosis de corticosteroides inhalados, aumento en la terapia y los despertares nocturnos en las últimas cuatro semanas (p < 0,001). El análisis multivariado mostró un mayor riesgo de usar medicación de rescate en fumadores y exfumadores, cuando aumentó el número de despertares nocturnos, en casos de autopercepción de asma parcialmente controlada o no controlada, o cuando el asma no está controlada en base al ACQ-5. CONCLUSIONES: Nuestro estudio identifica la posibilidad de utilizar el aumento de la medicación de rescate en la última semana como una señal de alarma para algunos parámetros de la enfermedad, como exacerbaciones, mal control del asma y gravedad de la enfermedad


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Antiasmáticos/uso terapêutico , Asma/epidemiologia , Sobremedicalização/estatística & dados numéricos , Corticosteroides/uso terapêutico , Asma/tratamento farmacológico , Budesonida/uso terapêutico , Estudos Transversais , Progressão da Doença , Hospitalização/estatística & dados numéricos , Fatores de Risco , Espanha/epidemiologia
12.
Allergol. immunopatol ; 47(6): 585-590, nov.-dic. 2019. graf
Artigo em Inglês | IBECS | ID: ibc-186552

RESUMO

Introduction and objectives: Transforming growth factor β1 (TGFβ1) and dysregulated microRNA-21 (miR-21) expression is associated with TGFβ/Smad signaling pathway activation and fibrosis. While calcitriol has been shown to improve airway remodeling in asthmatic mice, its mechanism remains unknown. In this study, the effect of calcitriol on the TGFβ/Smad signaling pathway and miR-21 expression in human bronchial fibroblasts was investigated to explore the mechanism of action of calcitriol and the inhaled glucocorticoid, budesonide, in airway remodeling. Materials and methods: Human bronchial fibroblasts were pretreated with budesonide, calcitriol, or budesonide plus calcitriol, and stimulated with TGFβ1 for 48h. Quantitative real-time PCR was used to determine the expression of miR-21. Western blot was used to determine airway remodeling-related proteins, TGFβ/Smad signaling pathway-related proteins, glucocorticoid receptor, and vitamin D receptor (VDR) expression. Results: Both budesonide and calcitriol down-regulated miR-21 expression in human bronchial fibroblasts, up-regulated Smad7 expression, and inhibited the expression of airway remodeling-related proteins. Both budesonide and calcitriol up-regulated the low expression of VDR induced by TGFβ1 in human bronchial fibroblasts. The expression of VDR in the combined treatment group (budesonide plus calcitriol) was significantly higher than that in the calcitriol treatment group. The expression of collagen type I in the combined treatment group was significantly lower than that in the calcitriol treatment group. Conclusions: Calcitriol can up-regulate the expression of VDR in human bronchial fibroblasts and exert an anti-airway remodeling effect. Budesonide can up-regulate the expression of VDR in human bronchial fibroblasts and enhance the inhibitory effect of calcitriol on airway remodeling


No disponible


Assuntos
Animais , Camundongos , Budesonida/uso terapêutico , Vitamina D/uso terapêutico , Fibroblastos/imunologia , Calcitriol/uso terapêutico , MicroRNAs/imunologia , Asma/imunologia , Fator de Crescimento Transformador beta1/imunologia , Western Blotting , Fator de Crescimento Transformador beta1/metabolismo , Análise de Variância
20.
Gastroenterol. hepatol. (Ed. impr.) ; 41(7): 458-471, ago.-sept. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-180633

RESUMO

La budesonida oral es un glucocorticoide de acción fundamentalmente local. En la especialidad de Aparato Digestivo, se emplea sobre todo en la enfermedad inflamatoria intestinal, aunque también en otras indicaciones. Esta revisión aborda aspectos acerca de la farmacología, la farmacodinámica y el empleo terapéutico de la budesonida. Se contemplan sus indicaciones reconocidas y se especula acerca de otras situaciones en las que podría desempeñar un papel de interés, con el objeto de facilitar su uso y mejorar la exactitud de su prescripción


Oral budesonide is a glucocorticoid of primarily local action. In the field of digestive diseases, it is used mainly in inflammatory bowel disease, but also in other indications. This review addresses the pharmacology, pharmacodynamics and therapeutic use of budesonide. Its approved indications are reviewed, as well as other clinical scenarios in which it could play a role, in order to facilitate its use and improve the accuracy of its prescription


Assuntos
Humanos , Anti-Inflamatórios/uso terapêutico , Budesonida/uso terapêutico , Doença de Crohn/tratamento farmacológico , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/efeitos adversos , Anti-Inflamatórios/farmacologia , Budesonida/administração & dosagem , Budesonida/efeitos adversos , Budesonida/farmacologia , Colite Ulcerativa/tratamento farmacológico , Ensaios Clínicos Controlados como Assunto , Doença de Crohn/cirurgia , Ileostomia , Complicações Pós-Operatórias/prevenção & controle , Guias de Prática Clínica como Assunto
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