The treatment of patients with asthma and comorbidity.

Abstract

The increa­sing prevalence of asthma (A) and diabetes mellitus type 2 (DM2T) necessitates administration of the adequate antia­sthmatic long-term basic therapy with consideration of comorbid states. The purpose consisted in revealing the therapeutic potential of Tiotropium bromide (TB) and L-arginine (Tivortine) in patients having uncontrolled moderately severe asthma in combination with DM2T (A+DM2T). Forty seven A+DM2T patients underwent an in-depth study before and after their treatment. They were divided into 2 groups: treatment (group 1, n=28) and comparison (group 2, n=19). Both groups received the standard 2-component therapy: budesonide/formoterol fumarate dihydrate – 160/4.5µg by 2 breaths twice a day and metformin at a dose of 500 mg twice a day. The complex of their basic therapy for group 1 additionally included TB (18 µg a day) and arginine hydrochloride preparation (Tivortine® aspartate, Yuriya-Farm) orally by 15 ml twice a day during 3 months (90 days). The patients were followed up 3 months and one year later. Their general condition demonstrated positive dynamics in both groups, the number of exacerbations in group 1 reducing by a factor of 4. The complex use of L-arginine and TB preparations against a background of the basic therapy in A+DM2T patients produced a better control over the disease, a more rapid elimination of obstruction manifestations, achievement and prolongation of the clinical spirographic remission, an improvement of the quality of life, correction of disturbances in haemocoagulation, fibrinolysis and the functional state of endothelium.

Keywords

• asthma
• diabetes mellitus type 2
• MCP-1
• MMP-9
• von Willebrand factor
• L-arginine
• Tiotropium bromide