Importancia y variabilidad de los síntomas en la EPOC. Su importancia para el tratamiento

López-Campos, José Luis

doi:10.1016/S0300-2896(10)70063-6

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La evaluación de los pacientes con enfermedad pulmonar obstructiva crónica ha dado un cambio en las últimas décadas con la incorporación de valoraciones subjetivas de los pacientes a las mediciones tradicionales basadas en función pulmonar. Una de las variables estudiadas más recientemente es la variabilidad de los síntomas durante el día y, específicamente, la percepción de estos síntomas durante las primeras horas del día. Para valorar este aspecto, recientemente se han desarrollado 2 nuevos cuestionarios de síntomas: el Capacity of Daily Living during the Morning Questionnaire y el Global Chest Symptoms Questionnaire. Hay estudios recientes que empiezan a aportar datos sobre el efecto de los tratamientos disponibles sobre estos síntomas matutinos. Los resultados de estos estudios muestran datos sobre la rapidez de acción de budesónida/ formoterol con un efecto en las actividades matutinas significativo y cercano a la relevancia clínica. De confirmarse estos resultados, esto podría conducir en un futuro hacia estrategias encaminadas a la mejoría sintomática más temprana que conllevara una adherencia mayor al tratamiento.

Palabras clave:

Enfermedad pulmonar obstructiva crónica

Actividades matutinas

Variabilidad clínica

Budesónida/formoterol

Cuestionarios

Abstract

Assessment of patients with COPD has changed in the last few years by adding subjective patient evaluations to traditional measurements based on pulmonary function. One of the most recently studied variables is symptom variability during the day and, specifically, patients’ perceptions of these symptoms in the first few hours of the day. To evaluate this feature, two new symptom questionnaires, the Capacity of Daily Living in the Morning (CDLM) questionnaire and the Global Chest Symptoms Questionnaire (GCSQ), have recently been developed. Recent studies have begun to provide data on the effect of the available treatments on these morning symptoms, yielding information on the rapidity of action of budesonide/formoterol with a significant and nearly clinically relevant effect on morning activities. Confirmation of these results could lead to future strategies designed to earlier symptomatic improvement, which could lead to greater treatment adherence.

Keywords:

Chronic obstructive pulmonary disease

Morning activities

Clinical variability

Budesonide/formoterol

Questionnaires

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