19 / 31
Neumol Pediatr 2016; 11 (1) Sup: S5-S19
C o n t e n i d o d i s p o n i b l e e n h t t p : / / www. n e umo l o g i a - p e d i a t r i c a . cl
S17
Consenso chileno SER-SOCHINEP para el manejo del asma severo en el niño
uso reduce la inflamación de la vía aérea y mejora la función
pulmonar
69
.
Dupilumab
Anticuerpo monoclonal recombinante completamente
humano, que actúa bloqueando la subunidad alfa del receptor
de IL-4, con lo que se inhibe la acción de IL-4 e IL-13. Se
administra por vía subcutánea. Su uso en adultos ha demostrado
una reducción significativa del número de exacerbaciones
acompañado de una mejoría de la función pulmonar y del grado
de control del asma
70,71
.
La Dra Ana María Herrera obtuvo un Grant de Laboratorio
Novartis para proyecto de investigación el año 2015. Los
demás autores no presentan conflicto de intereses
REFERENCIAS
1. Fischer GB, Camargos PA, Mocelin HT. The burden of asthma
in children: a Latin American perspective. Paediatr Respir Rev
2005; 6: 8-13.
2. Godard P, Chanez P, Siraudin L, Nicoloyannis N, Duru G. Costs
of asthma are correlated with severity: a 1-year prospective
study. Eur Respir J 2002; 19: 61–7.
3. Guilbert T W, Bacharier LB, Fitzpatrick AM. Severe asthma in
children. J Allergy Clin Immunol Pract 2014; 2: 489-500.
4. Bousquet J, Mantzouranis E, Cruz AA, Ait-Khaled N, Baenna-
Cagnani CE, Bleecker ER, et al. Uniform definition of asthma
severity, control, and exacerbations: document presented for
the World Health Organization Consultation on Severe Asthma. J
Allergy Clin Immunol 2010; 126: 926–38.
5. GINA: Update 2016 Disponible en:
www.ginasthma.com6. Chung KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ,
et al. International ERS/ATS guidelines on definition, evaluation
and treatment of severe asthma. Eur Respir J 2014; 43: 343–73.
7. Bush A, Zar HJ. WHO universal definition of severe asthma.
Curr Opin Allergy Clin Immunol 2011; 11: 115–21.
8. American Thoracic Society .Proceedings of the ATS workshop
on refractory asthma: current understanding, recommendations,
and unanswered questions.. Am J Respir Crit Care Med 2000;
162: 2341–51.
9. Bel EH, Sousa A, Fleming L, Bush A, Chung KF, Versnel J,
et al. Diagnosis and definition of severe refractory asthma: an
international consensus statement from the Innovative Medicine
Initiative (IMI). Thorax 2011; 66: 910–17.
10. Hedlin G, Bush A, Lodrup Carlsen K, Wennergren G, de
Benedictis FM, Melen E, et al. Problematic severe asthma in
children, not one problem but many: a GA2LEN initiative. Eur
Respir J 2010; 36: 196–201.
11. Bush A, Saglani S. Management of severe asthma in children.
Lancet 2010; 376: 814-25.
12. Bracken M, Fleming L, Hall P, Van Stiphout N, Bossley C,
Biggart E , et al. The importance of nurse-led home visits in the
assessments of children with problematic asthma. Arch Dis Child
2009; 94: 780–4.
13. Konradsen JR, Nordlund B, Lidegran M, Pedroletti C, Gronlund
H, van Hage M, et al. Problematic severe asthma: a proposed
approach to identifying children who are severely resistant to
therapy. Pediatr Allergy Immunol 2011; 22: 9–18.
14. Sharples J, Gupta A, Fleming L, Bossley CJ, Bracken –King
M, Hall P, et al. Long term
effectiveness of a staged assessment for paediatric problematic
severe asthma. Eur
Respir J 2012; 40: 264–7.
15. Bozzetto S, Carraro S, Zanconato S, Baraldi E. Severe asthma
in childhood: diagnostic and management challenge. Curr Opin
Pulm Med 2015, 21:16–21.
16. Fokkens W, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F,
et al. EPOS 2012: European position paper on rhinosinusitis
and nasal polyps. Rhinology 2012; 50: 1– 12.
17. Pijnenburg MW, Baraldi E, Brand PL, Carlsen KH, Eber E,
Frischer T, et al. Monitoring Asthma in Children. Eur Respir J
2015; 45: 906-25.
18. Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S,
Canonica GW, Casale TB, et al. Allergic Rhinitis and its impact in
Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Inmunol
2010; 126: 466-76.
19. Tolia V, Vandenplas Y. Systematic review: the extra-
oesophageal symptoms of gastro-oesophageal reflux disease in
children. Aliment Pharmacol Ther 2009; 29: 258–72.
20. Chan WW, Chiou E, Obstein Kl, tignor AS, Whitlock TL. The
efficacy of proton pump inhibitors for the treatment of asthma in
adults: a meta – analysis. Arch Intern Med 2011; 171: 620-9.
21. Holguin F, Bleecker ER, Busse WW, Calhoun WJ, Castro
M, Erzurum SC, et al. Obesity and asthma: an association
modified by age of asthma onset. J Allergy Clin Immunol. 2011
Jun;127:1486-93.
22. Scott HA, Gibson PG, Garg ML, Pretto JJ, Morgan PJ,
Callister R, et al. Dietary restriction and exercise improve airway