Effective integrated management of patients with chronic bronchitis: expert consensus statement
https://doi.org/10.15829/3034-4123-2024-28
EDN: JAYCDI
Abstract
The article presents an expert consensus statement on modern approaches to the management of patients with chronic bronchitis. The document emphasizes an interdisciplinary strategy for patient management, including risk factor modification, follow-up care, and prevention. Experts highlighted the importance of smoking cessation, vaccination, and individualized pharmacotherapy, including mucolytics and bronchodilators. The role of antibacterial therapy during exacerbations and the need for standardized follow-up approaches are also discussed. The consensus resulted in guidelines aimed at improving the quality of life of patients with chronic bronchitis and preventing disease progression.
About the Authors
O. M. DrapkinaRussian Federation
Moscow
S. N. Avdeev
Russian Federation
Moscow
L. Yu. Drozdova
Russian Federation
Moscow
M. I. Smirnova
Russian Federation
Moscow
L. Yu. Nikitina
Russian Federation
Moscow
R. N. Shepel
Russian Federation
Moscow
A. A. Yafarova
Russian Federation
Moscow
References
1. Avdeev SN, Demko IV, Zaytsev AA, et al. Federal guidelines on diagnosis and treatment of chronic bronchitis. Pulmonologiya. 2022;32(3):448-472. (In Russ.) doi:10.18093/0869-0189-2022-32-3-448-472.
2. Demko IV, Zaytsev AA, Ignatova GL, et al. Chronic bronchitis. Moscow: GEOTAR-Media, 2021. p.80. (In Russ.) doi:10.33029/9704-6503-5-XRB-2021-1-80. ISBN 978-5-9704-6503-5.
3. Miravitlles M, de la Roza C, Morera J, et al.. Chronic respiratory symptoms, spirometry and knowledge of COPD among general population. Respir Med. 2006;100(11):1973-80. doi:10.1016/j.rmed.2006.02.024.
4. Pelkonen M, Notkola IL, Nissinen A, et al. Thirty-year cumulative incidence of chronic bronchitis and COPD in relation to 30-year pulmonary function and 40-year mortality: a follow-up in middle-aged rural men. Chest. 2006;130(4):1129-37. doi:10.1378/chest.130.4.1129.
5. de Marco R, Accordini S, Cerveri I, et al. Incidence of chronic obstructive pulmonary disease in a cohort of young adults according to the presence of chronic cough and phlegm. Am J Respir Crit Care Med. 2007;175(1):32-9. doi:10.1164/rccm.200603-381OC.
6. Miravitlles M, Soriano JB, García-Río F, et al. Prevalence of COPD in Spain: impact of undiagnosed COPD on quality of life and daily life activities. Thorax. 2009;64(10):863-8. doi:10.1136/thx.2009.115725
7. Martinez C, Chen Y, Kazerooni E, et al. Non-obstructive chronic bronchitis in the COPDGene cohort [abstract]. Am J Respir Crit Care Med 2012;185:A6622.
8. Poole P, Sathananthan K, Fortescue R. Mucolytic agents versus placebo for chronic bronchitis or chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2019;5(5):CD001287. doi: 10.1002/14651858.CD001287.pub6.
9. Rogliani P, Matera MG, Page C, et al. Efficacy and safety profile of mucolytic/antioxidant agents in chronic obstructive pulmonary disease: a comparative analysis across erdosteine, carbocysteine, and N-acetylcysteine. Respir Res. 2019;20:104. doi:10.1186/s12931-019-1078-y.
10. Balsamo R, Lanata L, Egan CG. Mucoactive drugs. Eur Respir Rev. 2010;19(116):127-33. doi:10.1183/09059180.00003510.
11. Decramer M, Janssens W. Mucoactive therapy in COPD. Eur Respir Rev. 2010;19(116):134-40. doi:10.1183/09059180.00003610.
12. Santus P, Santus P, Corsico A, Solidoro P, et al. Oxidative stress and respiratory system: pharmacological and clinical reappraisal of N-acetylcysteine. COPD. 2014;11(6):705-17. doi:10.3109/15412555.2014.898040.
13. Papi A, Alfano F, Bigoni T, et al. N-acetylcysteine Treatment in Chronic Obstructive Pulmonary Disease (COPD) and Chronic Bronchitis/Pre-COPD: Distinct Meta-analyses. Arch Bronconeumol. 2024;60(5):269-278. doi:10.1016/j.arbres.2024.03.010.
14. British Thoracic Society Research Committee. Exacerbation rates in patients with chronic bronchitis and severe airway obstruction treated with oral N-acetylcysteine. Thorax. 1985;40(11):832-5. doi:10.1136/thx.40.11.832.
15. Pela R, Calcagni AM, Subiaco S, et al. N-acetylcysteine reduces the exacerbation rate in patients with moderate to severe COPD. Respiration. 1999;66(6):495-500. doi:10.1159/000029447.
16. Grassi C, Morandini GC. A controlled trial of intermittent oral acetylcysteine in the long-term treatment of chronic bronchitis. Eur J Clin Pharmacol. 1976;9:393-6.
17. Borgia M, Sepe N, Ori-Belometti M, et al. Comparison between acetylcysteine and placebo in the long-term treatment of chronic bronchitis [Confronto tra acetilcisteina e placebo nel trattamento a lungo termine della bronchite cronica]. Gazz Med Ital. 1981;140:467-72.
18. Tang W, Zhu D, Wu F, et al. Intravenous N-acetylcysteine in respiratory disease with abnormal mucus secretion. Eur Rev Med Pharmacol Sci. 2023;27(11):5119-5127. doi:10.26355/eurrev_202306_32628.
19. Anthonisen NR, Manfreda J, Warren CP, et al. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med. 1987;106(2):196-204. doi:10.7326/0003-4819-106-2-196.
Review
For citations:
Drapkina OM, Avdeev SN, Drozdova LY, Smirnova MI, Nikitina LY, Shepel RN, Yafarova AA. Effective integrated management of patients with chronic bronchitis: expert consensus statement. Primary Health Care (Russian Federation). 2024;1(2):28-36. (In Russ.) https://doi.org/10.15829/3034-4123-2024-28. EDN: JAYCDI