NEUMOLOGÍA PEDIÁTRICA

Neumol Pediatr 2021; 16 (32): 114 - 118 Revista Neumología Pediátrica | Contenido disponible en www.neumologia-pediatrica.cl 118 Asma en niños: una revisión en torno a los cambios en su tratamiento 1. Global Initiative for Asthma (GINA). Global strategy for asth- ma management and prevention (Updated 2021). Available from: www.ginasthma.org. Acceso junio, 2021. 2. A report from the National Asthma Education and Pre- vention Program Coordinating Committee Expert Panel Working Group. 2020 Focused Updates to The Asthma Management Guidelines. National Heart, Lung, and Blood Institute, National Institutes of Health; 2020. Available from: www.nhlbi.nih.gov . acceso Junio, 2021 3. Fitzpatrick AM, Bacharier LB, Jackson DJ, Szefler S, Beigel- man A, Cabana M, Covar R, et al. Heterogeneity of mild to moderate persistent asthma in children: confirmation by latent class analysis and association with 1-year outco- mes. J Allergy Clin Immunol Pract 2020;8(8):2617-27. DOI: 10.1016/j.jaip.2020.02.032 4. PapadopoulosNG, ČustovićA, CabanaMD, Dell SD, Deschil- dre A, Hedlin G, et al. Pediatric asthma: an unmet need for more effective, focused treatments. Pediatr Allergy Immu- nol 2019;30(1):7-16. DOI: 10.1111/pai.12990 5. FDA. FDA Requires Boxed Warning About Serious Mental Health Side Effects for Asthma and Allergy Drug Monte- lukast (Singulair); Advises Restricting Use for Allergic Rhini- tis. FDA; 2020. AccesoMayo 2021 6. Gema 5.1. Guía española para el manejo del asma [Inter- net] España: Sociedad Española de Neumología y Cirugía Torácica (SEPAR); c2020 [citada junio 2021]. Disponible en https://neumoped.org/actualizacion-gema-5-1/ 7. Bacharier LB, Phillips BR, Zeiger RS, Stanley J, Martinez F, Lemanske R, et al. Episodic use of an inhaled corticosteroid or leukotriene receptor antagonist in preschool children with moderate-to-severe intermittent wheezing. J Aller- gy Clin Immunol 2008;122(6):1127-35.e8. DOI: 10.1016/j. jaci.2008.09.029 8. Ducharme FM, Lemire C, Noya FJ, Davis GM, Alos N, Le- blond H, et al. Preemptive use of high-dose fluticasone for virus-induced wheezing in young children. N Engl J Med 2009;360(4):339-53. DOI: 10.1056/NEJMoa0808907 9. Svedmyr J, Nyberg E, Thunqvist P, Asbrink-Nilsson E, Hed- lin G. Prophylactic intermittent treatment with inhaled corticosteroids of asthma exacerbations due to airway infections in toddlers. Acta Paediatr 1999;88(1):42-7. DOI: 10.1080/08035259950170583 10. Martinez FD, Chinchilli VM, Morgan WJ, Boehmer SJ, Le- manske RF, Mauger D, et al. Use of beclomethasone dipropionate as rescue treatment for children with mild persistent asthma (TREXA): a randomised, double-blind, placebo-controlled trial. Lancet 2011;377(9766):650-7. doi: 10.1016/S0140-6736(10)62145-9 11. SuminoK, Bacharier LB, Taylor J, Chadwick-Mansker K, Cur- tis V, Nash A, et al. A pragmatic trial of symptom-based in- haled corticosteroid used in African-American Childrenwith Mild Asthma. J Allergy Clin Immunol Pract 2020;8(1):176- 85.e2. DOI: 10.1016/j.jaip.2019.06.030 12. Suissa S, Ernst P, Benayoun S, Baltzan M, Cai B. Low-dose inhaled corticosteroids and the prevention of death from asthma. N Engl J Med 2000;343(5):332-6. DOI: 10.1056/ NEJM200008033430504 13. Suissa S, Ernst P, Kezouh A. Regular use of inhaled corti- costeroids and the long-term prevention of hospitalisation for asthma. Thorax 2002;57(10):880-4. DOI: 10.1136/tho- rax.57.10.880 14. Reddel HK, Ampon RD, Sawyer SM, Peters MJ. Risks asso- ciated with managing asthma without a preventer: urgent healthcare, poor asthma control and over-the-counter re- liever use in a cross-sectional population survey. BMJ Open 2017;7(9):e016688. DOI: 10.1136/bmjopen-2017-016688 15. O’Byrne PM, FitzGerald JM, Bateman ED, Barnes PJ, Zhong N, Keen C, et al. Inhaled Combined Budesoni- de-Formoterol as Needed in Mild Asthma. N Engl J Med 2018;378(20):1865-76. doi: 10.1056/NEJMoa1715274 16. Bateman ED, Reddel HK, O’Byrne PM, Barnes PJ, Zhong N, Keen C, et al. As-Needed Budesonide-Formoterol versus Maintenance Budesonide in Mild Asthma. N Engl J Med 2018;378(20):1877-87. DOI: 10.1056/NEJMoa1715275 17. Pauwels RA, Pedersen S, Busse WW, Tan WC, Chen Y, Ohlsson S, et al. Early intervention with budesonide in mild persistent asthma: a randomised, double-blind trial. Lancet 2003;361(9363):1071-76. DOI: 10.1016/S0140- 6736(03)12891-7 18. Kaiser SV, Huynh T, Bacharier LB, Rosenthal JL, Bakel LA, Parkin P, et al. Preventing exacerbations in preschoolers with recurrent wheeze: a meta-analysis. Pediatrics [In- ternet] 2016;137(6):e20154496. DOI: 10.1542/peds.2015- 4496 19. Bitsko MJ, Everhart RS, Rubin BK. The adolescent with as- thma. Paediatr Respir Rev 2014;15(2):14-53. DOI: 10.1016/j. prrv.2013.07.003 20. Stempel DA, Szefler SJ, Pedersen S, Zeiger RS, Yeakey AM, Lee L, et al. Safety of Adding Salmeterol to Flutica- sone Propionate in Children with Asthma. N Engl J Med 2016;375(9):840-9. DOI: 10.1056/NEJMoa1606356 21. Yoshihara S, Tsubaki T, IkedaM, LenneyW, Tomiak R, Hattori T, et al. The efficacy and safety of fluticasone/salmeterol compared to fluticasone in children younger than four years of age. Pediatr Allergy Immunol 2019;30(2):195-203. DOI: 10.1111/pai.13010 22. Hatziagorou E, Kouroukli E, Galogavrou M, Papani- kolaou D, Terzi D, Anagnostopoulou P, et al. Efficacy and safety of the combination fluticasone propio- nate plus salmeterol in asthmatic preschoolers: an observational study. J Asthma 2019;56(6):573-80. DOI: 10.1080/02770903.2018.1474923 23. https://gskpro.com/content/dam/global/hcpportal/es_ AR/pdfs/homepage/products/seretide/ar-portal-IP-se- retideaerosol2017.pdf acceso junio 2021 24. O’Byrne PM, Bisgaard H, Godard PP, Pistolesi M, Palmqvist M, Zhu Y, et al. Budesonide/formoterol combination thera- py as both maintenance and reliever medication in asthma. AmJ Respir Crit CareMed 2005;171(2):129-36. DOI: 10.1164/ rccm.200407-884OC 25. Rabe KF, Pizzichini E, Stallberg B, Romero S, Balanzat AM, Atienza T, et al. Budesonide/formoterol in a single inhaler for maintenance and relief in mild-to-moderate asthma: a randomized, double-blind trial. Chest 2006;129(2):246-56. DOI: 10.1378/chest.129.2.246 26. Scicchitano R, Aalbers R, Ukena D, Manjra A, Fouquert L, Centanni S, et al. Efficacy and safety of budesonide/for- moterol single inhaler therapy versus a higher dose of bu- desonide inmoderate to severe asthma. Curr Med Res Opin 2004;20(9):1403-18. DOI: 10.1185/030079904X2051 27. Bisgaard H, Le Roux P, Bjamer D, Dymek A, Vermeulen JH, Hultquist C. Budesonide/formoterol maintenance plus reliever therapy: a new strategy in pediatric asthma. Chest 2006;130(6):1733-43. DOI: 10.1378/chest.130.6.1733 28. Jorup C, Lythgoe D, Bisgaard H. Budesonide/formote- rol maintenance and reliever therapy in adolescent pa- tients with asthma. Eur Respir J 2018;51(1):1701688. doi: 10.1183/13993003.01688-2017 29. Papi A, Corradi M, Pigeon-Francisco C, Baronio R, Siergiejko Z, Petruzzelli S, et al. Beclometasone-formoterol as main- tenance and reliever treatment in patients with asthma: a double-blind, randomised controlled trial. Lancet Respir Med 2013;1(1):23-31. DOI: 10.1016/S2213-2600(13)70012-2 30. Vega-Briceño L. Asma leve: un problema de salud pública invisible. Neumol Pediatr 2021;16(2):90-91. DOI: 10.51451/ np.v16i2.330 REFERENCIAS nes no condicen con los pasos del tratamiento según cada grupo de edad, lo que traduce una discrepancia entre los autores que sugieren ambos esquemas. Si bien las guías clínicas deberían facilitar la elección de la mejor opción controladora y rescatadora del asma leve-mo- derada en niños y adolescentes, parece que la interpretación de la misma evidencia puede diferir dependiendo de quienes sean sus auto- res; produciendo más confusión que claridad a la hora de prescribir uno u otro esquema. A la luz de esta revisión parece necesario una estrategia de tratamiento personalizada no sólo considerando la severidad del asma, sino también la importancia de la educación y ad- herencia en todos los pasos, la percepción de síntomas de cada paciente y el impacto futuro de la enfermedad y los costos asociados a es- tos esquemas de tratamientos intermitentes Conflicto de interés: El autor declara ser Asesor Medico GSK.