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Web Forum 21.12.17 ore 11.30

#21
Crede che sia davvero vincente la scelta della terapia tripla a dose fissa extrafine ICS/LABA/LAMA nei pazienti BPCO?
#22
La BPCO è ad oggi una patologia ancora sottodiagnosticata, In Italia, dove le malattie dell'apparato respiratorio costituiscono la terza causa di morte, la BPCO rappresenta il 50-55% delle morti per malattie dell'apparato respiratorio e la 7a causa di ospedalizzazione. Sempre in Italia, i malati di BPCO sarebbero circa 5 milioni (poco meno del 10% della popolazione) e le morti annuali per BPCO sarebbero circa 17.000. Nei prossimi 10 anni, a causa dell'inquinamento atmosferico e del fumo di tabacco, la prevalenza della BPCO aumenterà del 50% negli uomini e addirittura del 130% nelle donne.

Credo nella necessità di fenotipizzare il paziente BPCO che abbiamo difronte. Una triplice terapia può di certo essere indicata in un BPCO ad alto rischio (FEV1<50%, mMRC >2 e CAT>10, frequenti riacutizzazioni), ancor di più bronchitico cronico e/o in presenza di eosinofilia >3% nel sangue periferico. La formulazione extra-fine senza dubbio dimostra una valenza importante nel trattamento anche dell'ostruzione a carico delle piccole vie aeree.

Le infezioni respiratorie nella prima infanzia sembrano associarsi ad una maggiore predisposizione al declino rapido della funzionalità respiratoria e quindi insorgenza più precoce della BPCO in presenza di fattore di rischio quale fumo di sigaretta.

Arrivederci. Alla prossima. Grazie a tutti
#23
Ringraziamo vivamente la Prof.ssa Carpagnano per i suoi contributi.

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