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Бронхиальная астма: принципиальные изменения в новом руко водстве GINA (2019) / Bronchial asthma: fundamental changes in the new GINA guidelines (2019)

DOI: http://dx.doi.org/10.21518/1561-5936-2020-9-46-50

Алексей Водовозов, врач-терапевт высшей категории, «Ремедиум»

Новое руководство Глобальной инициативы по бронхиальной астме (GINA) вызвало бурное обсуждение специалистов. В 2018 г. была опубликована очередная версия, но уже в 2019 г. появился ее пересмотр. В первую очередь это связано с пересмотром отношения к бета-2-агонистам короткого действия, однако и на других этапах лечения бронхиальной астмы, особенно на ранних, подходы существенно изменились. Акцент сделан на низкодозовых ингаляционных кортикостероидах, поскольку по ним накопилась достаточно качественная доказательная база. По сути, предложения GINA 2019 г. сводятся к отказу от сложившейся клинической практики и переходу к принципиально иным подходам ведения бронхиальной астмы, прежде всего, легкой ее формы.

Aleksey Vodovozov, a general practitioner of the highest qualification grade, Remedium

The new guidelines of the Global Initiative for Asthma (GINA) has inspired a heated discussion among experts. The next version was published in 2018, but its revision appeared as early as in 2019. This is primarily due to the revision of the attitude towards short-acting beta-2-agonists, however, the approaches have changed significantly at other stages of bronchial asthma treatment as well, especially at the early stages. The emphasis has been placed on low-dose inhaled corticosteroids, as they have accumulated an evidence base at an adequate quality level. In fact, the 2019 GINA proposals are reduced to discontinuation of the common clinical practice and switching to fundamentally different approaches to the management of bronchial asthma, especially its mild form.

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Ключевые слова: GINA, бронхиальная астма, ингаляционные кортикостероиды, бета-2-агонисты, клиническое руководство, bronchial asthma, inhaled corticosteroids, beta-2 agonists, clinical guidelines

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