Pharmacologic Strategies for Exercise-Induced Bronchospasm with a Focus on Athletes - 09/04/18

Doi : 10.1016/j.iac.2018.01.011

Vibeke Backer, MD, DMSci ^a,^⁎ , John Mastronarde, MD, MSc ^b
^a Department of Respiratory Medicine, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen NV 2400, Denmark
^b Department of Medical Education, Providence Portland Medical Center, Pulmonary/Critical Care Medicine, Oregon Health & Science University, 5050 Northeast Hoyt Avenue, Suite 540, Portland, OR 97213, USA

^∗Corresponding author.

Résumé

Exercise-induced bronchoconstriction (EIB) is the transient narrowing of the airways during and after exercise that occurs in response to increased ventilation in susceptible individuals. It occurs across the age spectrum in patients with underlying asthma and can occur in athletes without baseline asthma. The inflammatory mechanisms underlying EIB in patients without asthma may be distinct from those underlying EIB in patients with asthma. This review summarizes mechanistic and clinical data that can guide the choice of chronic and acute pharmacologic therapies targeting control of EIB. Relevant regulations from the World Anti-Doping Agency are also discussed.

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Keywords : Exercise, Asthma, Treatment, EIB, Doping

Plan

Key points

Introduction

Overview of pharmacologic therapy for exercise-induced bronchoconstriction

Short-Acting Beta₂ Agonists: First-Line Therapy for Exercise-Induced Bronchoconstriction

Alternative First-Line Therapies and Additions to Short-Acting Beta-Agonist Therapy

Mast cell stabilizing agents

Anticholinergic agents

Scientific experience with multidrug therapy for exercise-induced bronchoconstriction

Approach to patients with difficult-to-manage exercise-induced bronchoconstriction

Exercise-induced bronchoconstriction therapy stratified by endo-type

Treatment of acute exacerbation in elite athletes and the doping perspective

Summary

Disclosure Statement: None of the authors has anything to disclose or any conflicts of interest. V. Backer has received support from the World Anti-Doping Agency for asthma therapy evaluation in elite athletes.

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Vol 38 - N° 2

P. 231-243 - mai 2018 Retour au numéro

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Pharmacologic Strategies for Exercise-Induced Bronchospasm with a Focus on Athletes - 09/04/18

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