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Novas abordagens farmacológicas no tratamento da asma
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A asma é um problema mundial, estimando-se que afecta cerca de 300 milhões de pessoas.
O actual tratamento para esta patologia baseia-se numa abordagem em etapas, que depende da gravidade da doença e tem como objectivo reduzir os sintomas que resultam da inflamação e obstrução das vias aéreas, sendo a combinação de glucocorticóides e agonistas dos receptores adrenérgicos β2 de longa acção (LABA) inalados o tratamento disponível mais eficaz.
Apesar de grandes avanços na terapêutica, os sintomas de doentes com asma grave refractária, que representam entre 5 a 10% dos doentes asmáticos, não estão adequadamente controlados e são quem mais precisa de novas abordagens mais eficazes para melhorar o controlo da asma e reduzir o risco de exacerbações.
Muitos novos tratamentos, como os inibidores das citocinas, são muito específicos, tendo como alvo um único mediador ou receptor, e apesar de ser improvável que tenham um grande efeito clínico, podem ser eficazes em fenótipos específicos da asma. Fármacos com efeitos mais generalizados, como inibidores das cinases, podem ser mais eficazes mas ter um maior risco de efeitos adversos.
Melhores abordagens de imunoterapia têm a perspectiva de modificar a doença, embora a perspectiva de uma cura para a asma ligeira a moderada esteja ainda distante.
Asthma is a worldwide problem, with an estimated 300 million affected people. The current treatment for this disease is based on a stepwise approach, depending on disease severity, and the aim is to reduce the symptoms that result from airway inflammation and obstruction, being the combination of inhaled glucocorticoid and long-acting β2 adrenoceptor agonist (LABA) the most effective current therapy. Despite great advances in therapy, the symptoms of patients with severe refractory asthma, that represent between 5 to 10% of all asthmatic patients, are not adequately controlled and are whom the most require more effective new approaches to improve asthma control and reduce exacerbation risk. Many new treatments, such as cytokines inhibitors, are too specific, targeting a single mediator or receptor and, although unlikely to have a major clinical effect, they might be effective in specific asthma phenotypes. Drugs with more widespread effects, such as kinase inhibitors, might be more effective but have a greater risk of side effects. Improved immunotherapy approaches have the prospect of disease modification, although prospects for a cure of mild to moderate asthma are currently remote.
Asthma is a worldwide problem, with an estimated 300 million affected people. The current treatment for this disease is based on a stepwise approach, depending on disease severity, and the aim is to reduce the symptoms that result from airway inflammation and obstruction, being the combination of inhaled glucocorticoid and long-acting β2 adrenoceptor agonist (LABA) the most effective current therapy. Despite great advances in therapy, the symptoms of patients with severe refractory asthma, that represent between 5 to 10% of all asthmatic patients, are not adequately controlled and are whom the most require more effective new approaches to improve asthma control and reduce exacerbation risk. Many new treatments, such as cytokines inhibitors, are too specific, targeting a single mediator or receptor and, although unlikely to have a major clinical effect, they might be effective in specific asthma phenotypes. Drugs with more widespread effects, such as kinase inhibitors, might be more effective but have a greater risk of side effects. Improved immunotherapy approaches have the prospect of disease modification, although prospects for a cure of mild to moderate asthma are currently remote.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2013
Palavras-chave
Asma Tratamento Novas abordagens Novos alvos terapêuticos Mestrado Integrado - 2013