Arquivos de Asma, Alergia e Imunologia
https://www.aaai-asbai.org.br/article/doi/10.5935/2526-5393.20200002
Arquivos de Asma, Alergia e Imunologia
Artigo Especial

Guia prático de abordagem da criança e do adolescente com asma grave: Documento conjunto da Associação Brasileira de Alergia e Imunologia e Sociedade Brasileira de Pediatria

Practical guide to approaching children and adolescents with severe asthma: a joint document of the Brazilian Association of Allergy and Immunology and the Brazilian Society of Pediatrics

Herberto J. Chong-Neto; Gustavo F. Wandalsen; Antonio C. Pastorino; Caroline Dela Bianca; Débora C. Chong-Silva; Carlos A. Riedi; José Dirceu Ribeiro; Nelson A. Rosário; Fábio C. Kuschnir; Emanuel C. Sarinho; Neusa F. Wandalsen; Fernanda C. Lanza; Adriana A. Antunes; Maria de Fátima P. March; Renato Kfouri; Luciana R. Silva; Flávio Sano; Dirceu Solé

Downloads: 0
Views: 59

Resumo

Asma grave é a asma que requer tratamento com altas doses de corticosteroide inalado associado a um segundo medicamento de controle (e/ou corticosteroide sistêmico) para impedir que se torne “descontrolada” ou permaneça “descontrolada” apesar do tratamento. Asma grave é considerada um subtipo de asma de difícil tratamento. A prevalência em crianças evidenciada pelo International Study of Asthma and Allergies in Childhood variou entre 3,8% e 6,9%. Existem diversos instrumentos para avaliação subjetiva, como diários de sintomas e questionários, bem como para avaliação objetiva com função pulmonar e avaliação da inflamação por escarro induzido, ou óxido nítrico exalado. A abordagem terapêutica varia desde doses altas de corticosteroide inalado e/ou oral, broncodilatadores de longa duração, antaganonistas de receptores muscarínicos, até os mais recentes imunobiológicos que bloqueiam a IgE ou IL-5.

Palavras-chave

Criança, asma grave, imunobiológicos.

Abstract

Severe asthma is asthma that requires treatment with high doses of inhaled corticosteroids in combination with a second control drug (and/or a systemic corticosteroid) to prevent it from becoming "uncontrolled" or remaining "uncontrolled" despite treatment. Severe asthma is considered a difficult-to-treat asthma subtype. The prevalence in children found by the International Study of Asthma and Allergies in Childhood ranged from 3.8% to 6.9%. There are several instruments for subjective assessment, such as symptom diaries and questionnaires, as well as for objective assessment, including pulmonary function testing and evaluation of inflammation by induced sputum or exhaled nitric oxide. The therapeutic approach includes high doses of inhaled and/or oral corticosteroids, long-acting bronchodilators, muscarinic receptor antagonists, and the latest biologics that block IgE or IL-5.

Keywords

Child, severe asthma, biologics.

Referências

1. 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.

2. Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention. 2019 – up date. Disponível em: http://www.ginasthma.org. Acessado em: 18/11/2019.

3. Lai CK, Beasley R, Crane J, Foliaki S, Shah J, Weiland S. Global variation in the prevalence and severity of asthma symptoms: phase three of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax. 2009; 64:476-83.

4. Centers for Disease Control and Prevention. 2014 National Health Interview Survey (NHIS) data; Table 4-1 Current asthma prevalence percents by age, United States: National Health Interview Survey. Disponível em: https://www.cdc.gov/asthma/nhis/2014/table4-1.htm. Acessado em: 18/11/2019.

5. Fleming L, Wilson N, Bush A. Difficult to control asthma in children. Curr Opin Allergy Clin Immunol. 2007;7:190-5.

6. Centers for Disease Control and Prevention. Asthma in the US [site na Internet]. Disponível em: https://www.cdc.gov/vitalsigns/asthma/.Acessado em: 18/11/2019.

7. Fitzpatrick AM. Severe asthma in children: lessons learned and future directions. J Allergy Clin Immunol Pract. 2016;4:11-9.

8. Szefler SJ, Zeiger RS, Haselkorn T, Mink DR, Kamath TV, Fish JE, et al. Economic burden of impairment in children with severe or difficultto-treat asthma. Ann Allergy Asthma Immunol. 2011;107:110-9.

9. Centers for Disease Control and Prevention. Asthma-related missed school days among children aged 5 to 17 years [site na Internet]. Disponível em: https://www.cdc.gov/asthma/asthma_stats/missing_days.htm. Acessado em: 18/11/2019.

10. Moonie SA, Sterling DA, Figgs L, Castro M. Asthma status and severity affects missed school days. J Sch Health. 2006;76:18‑24.

11. Bellin MH, Osteen P, Kub J, Bollinger ME, Tsoukleris M, Chaikind L, et al. Stress and quality of life in urban caregivers of children with poorly controlled asthma: a longitudinal analysis. J Pediatr Health Care. 2015;29:536-46.

12. Dinakar C, Chipps BE. Clinical tools to assess asthma control in children. Pediatrics. 2017;139:e20163438.

13. Licari A, Brambilla I, Marseglia A, De Filippo M, Paganelli V, Marseglia GL. Difficult vs. Severe Asthma: Definition and Limits of Asthma Control in the Pediatric Population. Front Pediatr. 2018;6:170.

14. Santanello NC, Davies G, Galant SP, Pedinoff A, Sveum R, Seltzer J, et al. Validation of an asthma symptom diary for interventional studies. Arch Dis Child. 1999;80:414‑20.

15. Santanello NC, Demuro-Mercon C, Davies G, Ostrom N, Noonan M, Rooklin A, et al. Validation of a pediatric asthma caregiver diary. J Allergy Clin Immunol. 2000;106:861‑6.

16. Santanello NC, Barber BL, Reiss TF, Friedman BS, Juniper EF, Zhang J. Measurement characteristics of two asthma symptom diary scales for use in clinical trials. Eur Respir J. 1997;10:646‑51.

17. Juniper EF, O'Byrne PM, Ferrie PJ, King DR, Roberts JN. Measuring asthma control. Clinic questionnaire or daily diary? Am J Respir Crit Care Med. 2000;162:1330‑4.

18. Skinner EA, Diette GB, Algatt-Bergstrom PJ, Nguyen TT, Clark RD, Markson LE, et al. The Asthma Therapy Assessment Questionnaire (ATAQ) for children and adolescents. Dis Manag. 2004;7(4):305‑13.

19. Chipps B, Zeiger RS, Murphy K, Mellon M, Schatz M, Kosinski M, et al. Longitudinal validation of the Test for Respiratory and Asthma Control in Kids in pediatric practices. Pediatrics. 2011;127(3):e737‑e747.

20. Cloutier MM, Schatz M, Castro M, Clark N, Kelly HW, MangioneSmith R, et al. Asthma outcomes: composite scores of asthma control. J Allergy Clin Immunol. 2012;129(3 Suppl):S24‑S33.

21. Brand PL, Mäkelä MJ, Szefler SJ, Frischer T, Price D; ERS Task Force Monitoring Asthma in Children. Monitoring asthma in childhood: symptoms, exacerbations and quality of life. Eur Respir Rev. 2015;24(136):187‑93.

22. Chipps BE, Zeiger RS, Dorenbaum A, Borish L, Wenzel SE, Miller DP, et al. Assessment of asthma control and asthma exacerbations in the epidemiology and natural history of asthma: outcomes and treatment regimens (TENOR) observational cohort. Curr Respir Care Rep. 2012;1(4):259‑69.

23. Jackson DJ, Sykes A, Mallia P, Johnston SL. Asthma exacerbations: origin, effect, and prevention. J Allergy ClinImmunol. 2011;128(6):1165‑74.

24. Wandalsen GF, Dias RG, Chong-Neto HJ, Rosário N, Moraes L, Wandalsen NF, et al. Test for respiratory and asthma control in kids (TRACK): validation of the portuguese version. World Allergy Organ J. 2018;11:40.

25. Gherasim A, Dao A, Bernstein JA. Confounders of severe asthma: diagnoses to consider when asthma symptoms persist despite optimal therapy. World Allergy Organ J. 2018;11(1):29.

26. Ribeiro JD, Fischer GB. Chronic obstructive pulmonary diseases in children. J Pediatr (Rio J). 2015;91(6 Suppl 1):S11-25.

27. Tillie-Leblond I. Difficult Childhood Asthma: Management and Future. Clin Chest Med. 2012;33:485‑503.

28. Barsky EE, Giancola LM, Baxi SN, Gaffin JM. A practical approach to severe asthma in children. Ann Am Thorac Soc. 2018;15(4):399‑408.

29. Guilbert TW, Bacharier LB, Fitzpatrickc AM. Severe asthma in children. J Allergy Clin Immunol Pract. 2014;2(5):489‑500.

30. Schoettler N, Strek ME. Recent Advances in Severe Asthma: From Phenotypes to Personalized Medicine. Chest. 2019 Oct 31 pii: S0012-3692(19)34108-X.

31. Rodrigues AM, Roncado C, Santos G, Heinzmann-Filho JP, Souza RG, Vargas MHM, et al. Características clínicas de crianças e adolescentes brasileiros com asma grave resistente a terapia. J Bras Pneumol. 2015;41(4):343-50.

32. Saglani S, Payne DN, Zhu J, Wang Z, Nicholson AG, Bush A, et al. Early detection of airway wall remodeling and eosinophilic inflammation in preschool wheezers. Am J Respir Crit Care Med. 2007;176(9):858-64.

33. Payne DN, Rogers AV, Adelroth E, Bandi V, Guntupalli KK, Bush A, et al. Early thickening of the reticular basement membrane in children with difficult asthma. Am J Respir Crit Care Med. 2003;167(1):78‑82.

34. Queiroz MVNP, Alvim CG, Cruz AA, Lasmar LMLBF. Lung function in severe pediatric asthma: a longitudinal study in children and adolescents in Brazil. Clin Transl Allergy. 2017;7:48.

35. Piccioni P, Tassinari R, Carosso A, Carena C, Bugiani M, Bono R. Lung function changes from childhood to adolescence: a seven-year follow-up study. BMC Pulm Med. 2015;15:31.

36. Siroux V, Boudier A, Dolgopoloff M, Chanoine S, Bousquet J, Gormand F, et al. Forced mid expiratory flow between 25% and 75% of forced vital capacity is associated with long-term persistence of asthma and poor asthma outcomes. J Allergy ClinImmunol. 2016;137(6):1709-16.

37. Coverstone AM, Bacharier LB, Wilson BS, Fitzpatrick AM, Teague WG, Phipatanakul W. Clinical significance of the bronchodilator response in children with severe asthma. Pediatr Pulmonol. 2019;54(11):1694-703.

38. Tantisira K, Fuhlbrigge A, Tonascia J, Natta MV, Zeiger RS, Strunk RC, et al. Childhood Asthma Management Program Research. Bronchodilation and bronchoconstriction: predictors of future lung function in childhood asthma. J Allergy ClinImmunol. 2006;117:1264‑71.

39. de Oliveira Jorge PP, de Lima JHP, Chong e Silva DC, Medeiros D, Solé D, Wandalsen GF. Impulse oscillometry in the assessment of children’s lung function. Allergol Immunopathol (Madr). 2019;47(3):295-302.

40. de Oliveira Jorge PP, de Lima JHP, Wandalsen GF, Sole D. Avaliação de oscilometria de impulso em pré-escolares sibilantes. Arq Asma Alerg Imunol. 2017;1(Supl 1):S16.

41. Ai-Hua Cui, MM, Jing Zhao MM, Shu-Xiang Liu MM, Ying-Shuang Hao MB. Associations of IL-4, IL-6, and IL-12 levels in peripheral blood with lung function, cellular immune function, and quality of life in children with moderate-to-severe asthma. Medicine. 2017;96:12.

42. Falcai A, Soeiro-Pereira PV, Kubo CA, Aranda CS, Solé D, Condino-Neto A. Peripheral blood mononuclear cells from severe asthmatic children release lower amounts of IL-12 and IL-4 after LPS stimulation. Allergol Immunopathol (Madr). 2015;43(5):482‑6.

43. Kansal P, Nadan D, Agawal S, Patharia N, Arya N. Correlation of induced sputum eosinophil levels with clinical parameters in mild and moderate persistent asthma in children aged 7-18 years. J Asthma (online). Disponível em: http://www.tandfonline.com/loi/ijas20. Acessado em: 10/11/2019.

44. Ullmann N, Bossley CJ, Fleming L, Silvestri M, Bush A, Saglani S. Blood eosinophil counts rarely reflect airway eosinophilia in children with severe asthma. Allergy. 2013;68:402‑6.

45. Bitencourt ES, Eli D, Cunha R, Ribas D, Chong-Neto HJ, Riedi CA, et al. Endótipo da asma grave na criança: estamos sempre diante da asma eosinofílica? Arq Asma Alerg Imunol. 2019;1(Supl 1):S83.

46. Eller MCN. Avaliação do perfil inflamatório dos pacientes pediátricos com asma grave e sua correlação com o controle da doença e parâmetros funcionais [dissertação]. São Paulo (SP): FMUSP; 2018.

47. Salviano LDS, Taglia-Ferre KD, Lisboa S, Costa ACC, Campos HS, March MFP. Associação entre a fração exalada de óxido nítrico e dados da espirometria e controle clínico da asma em crianças e adolescentes. Rev Paul Pediatr. 2018;36(1):17-24.

48. Malinovschi A, Janson C, Borres M, Alving K. Simultaneous lyincreased fraction of exhaled nitric oxide levels and blood eosinophil counts relate to increased asthma morbidity. J Allergy Clin Immunol. 2016;138(5):1301-8.

49. Weinmayr G, Forastiere F, Buchele G, Weinmayr G, Forastiere F, Büchele G, et al. Overweight/obesity and respiratory and allergic disease in children: international study of asthma and allergies in childhood (ISAAC) phase two. PLoSOne. 2014; 9:e113996.

50. Mebrahtu TF, Feltbower RG, Greenwood DC, Parslow RC. Childhood body mass index and wheezing disorders: a systematic review and meta-analysis Pediatr Allergy Immunol. 2015;26(1):62-72.

51. Frey U, Latzin P, Usemann J, Maccora J, Zumsteg U, Kriemler S. Asthma and obesity in children: current evidence and potential systems biology approaches. Allergy. 2015;70(1):26‑40.

52. Lu KD, Breysse PN, Diette GB, Curtin-Brosnan J, Aloe C, Williams DL, et al. Being overweight increases susceptibility to indoor pollutants among urban children with asthma. J Allergy Clin Immunol. 2013;131:1017‑23.

53. Peters U, Dixon A, Forno E. Obesity and Asthma. J Allergy Clin Immunol. 2018;141(4):1169‑79.

54. Diaz J, Farzan S. Clinical Implications of the Obese-Asthma Phenotypes. Immunol Allergy Clin N Am. 2014;34:739‑51.

55. Castro-Rodríguez JA, Holberg CJ, Morgan WJ, Wright AL, Martinez FD. Increased incidence of asthmalike symptoms in girls who become overweight or obese during the school years. Am J Respir Crit Care Med. 2001;163(6):1344-9.

56. Sharma N, Akkoyunlu M, Rabin RL. Macrophages-common culprit in obesity and asthma. Allergy. 2018;73(6):1196-205.

57. Wood LG. Metabolic dysregulation. Driving the obese asthma phenotype in adolescents?Am J Respir Crit Care Med. 2015;191:121‑2.

58. Kuschnir FC, Felix MMR, Kuschnir MC, Bloch KV, EOC Jordão, Solé D, et al. Severe asthma is associated with metabolic syndrome in Brazilian adolescents. J Allergy Clin Immunol. 2018;141(5):1947‑9.

59. Okubo Y, Nochioka K, Hataya H, Sakakibara H, Terakawa T, Testa M. Burden of Obesity on Pediatric Inpatients with Acute Asthma Exacerbation in the United States. J Allergy Clin Immunol Pract. 2016; 4:1227‑31.

60. Forno E, Lescher R, Strunk R, Weiss S, Fuhlbrigge A, Celedon JC, et al. Decreased response to inhaled steroids in overweight and obese asthmatic children. J Allergy Clin Immunol. 2011;127:741‑9.

61. Ahmadizar F, Vijverberg SJ, Arets HG, de Boer A, Lang JE, Kattan M, et al. Childhood obesity in relation to poor asthma control and exacerbation: a meta-analysis. Eur Respir J. 2016;48:1063‑73.

62. Lang JE, Hossain MJ, Lima JJ. Overweight children report qualitatively distinct asthma symptoms: analysis of validated symptom measures. J Allergy Clin Immunol. 2015;135:886‑93.

63. Lang JE, Hossain J, Holbrook JT, Teague WG, Gold BD, Wise RA, et al. Gastro-oesophageal reflux and worse asthma control in obese children: a case of symptom misattribution? Thorax. 2016;71:238‑46.

64. Ricketts HC, Cowan DC. Asthma, obesity and targeted interventions. an update.Curr Opin Allergy Clin Immunol. 2019;19:68‑74.

65. Havemann BD, Henderson CA, El-Serag HB. The association between gastro-oesophageal reflux disease and asthma: a systematic review. Gut. 2007;56(12):1654‑64.

66. Thakkar K, Boatright RO, Gilger MA, El-Serag HB. Gastroesophageal reflux and asthma in children: a systematic review. Pediatrics. 2010;125(4):e925‑30.

67. Blake K, Teague WG. Gastroesophageal reflux disease and childhood asthma.Curr Opin Pulm Med. 2013;19(1):24‑9.

68. MiceliSopa S, Radzik D, Calvani M. Does treatment with proton pump inhibitors for gastroesphogeal reflux disease (GERD) improve asthma symptoms in children with asthma and GERD? A systematic review. J Investig Allergol Clin Immunol. 2009;19(1):1‑5.

69. Stordal K, Johannesdottir G, Bentsen B. Acid suppression does not change respiratory symptoms in children with asthma and gastroesophageal reflux disease. Arch Dis Child. 2005;90:956‑60.

70. Holdbrook J, Wise R, Gold B. Lansoprazole for children with poorly controlled asthma: a randomized clinical trial. JAMA. 2012;307:373‑81.

71. Dachs R, Endres J, Graber MA. PPIs, childhood asthma, and the problem of therapeutic creep. Am Fam Physician. 2014;15;89(6):476‑80.

72. Gimenez LM, Zafra H. Vocal cord dysfunction: an update. Ann Allergy Asthma Immunol. 2011;106(4):267‑74.

73. Johansson H, Norlander K, Berglund L, Janson C, Malinovschi A, Nordvall L, et al. Prevalence of exercise-induced bronchoconstriction and exercise-induced laryngeal obstruction in a general adolescent population. Thorax. 2015;70(1):57‑63.

74. Hseu A, Sandler M, Ericson D, Ayele N, Kawai K, Nuss R. Paradoxical vocal fold motion in children presenting with exercise induced dyspnea. Int J Pediatr Otorhinolaryngol. 2016;90:165‑9.

75. Petrov AA. Vocal Cord Dysfunction: The Spectrum Across the Ages. Immunol Allergy Clin N Am. 2019;39(4):547-60.

76. Maturo S, Hill C, Bunting G, Baliff C, Ramakrishna J, Scirica C, et al. Pediatric paradoxical vocal-fold motion: presentation and natural history. Pediatrics. 2011;128:e1443‑9.

77. Traister RS, Fajt ML, Petrov AA. The morbidity and cost of vocal cord dysfunction misdiagnosed as asthma. Allergy Asthma Proc. 2016;37(2):25‑31.

78. Morris MJ, Christopher KL. Diagnostic criteria for the classification of vocal cord dysfunction. Chest. 2010;138(5):1213‑23.

79. Traister RS, Fajt ML, Landsittel D, Petrov AA. A novel scoring system to distinguish vocal cord dysfunction from asthma. J Allergy Clin Immunol In Pract. 2014;2(1):65‑9.

80. Ferster AP, Shokri T, Carr M. Diagnosis and treatment of paradoxical vocal fold motion in infants. Int J Pediatr Otorhinolaryngol. 2018;107:6‑9.

81. Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications Chest. 2014;146(5):1387-94.

82. Gulotta G, Iannella G, Vicini C, Polimeni A, Greco A, de Vincentiis M, et al. Risk factors for obstructive sleep apnea syndrome in children: state of the art. Int J Environ Res Public Health. 2019;16(18). pii: E3235.

83. Salles C, Terse-Ramos R, Souza-Machado A, Cruz AA. Obstructive sleep apnea and asthma. J Bras Pneumol. 2013;39(5):604-12.

84. Min YZ, Subbarao P, Narang I. The bidirectional relationship between asthma and obstructive sleep apnea: which came first? J Pediatr. 2016;176:10‑6.

85. Desager KN, Nelen V, Weyler JJ, De Backer WA. Sleep disturbance and daytime symptoms in wheezing school-aged children. J Sleep Res. 2005;14:77-82.

86. Sulit LG, Storfer-Isser A, Rosen CL, Kirchner HL, Redline S. Associations of obesity, sleep-disordered breathing, and wheezing in children. Am J Respir Crit Care Med. 2005;171:659-64.

87. Ross KR, Storfer-Isser A, Hart MA, Kibler AM, Rueschman M, Rosen CL, et al. Sleep-disordered breathing is associated with asthma severity in children. J Pediatr. 2012;160:736-42.

88. Togias A. Rhinitis and asthma: evidence for respiratory system integration. J Allergy ClinImmunol. 2003;111(6):1171‑83.

89. Choi SH, Kim DK, Yoo Y, Yu J, Koh YY.Comparison of delta FVC between patients with allergic rhinitis with airway hypersensitivity and patients with mild asthma. Ann Allergy Asthma Immunol. 2007;98:128‑33.

90. Ciprandi G, Cirillo I, Pistorio A. Impact of allergic rhinitis on asthma: effects on spirometric parameters. Allergy. 2008;63:255‑60.

91. Jouaville LF, Annesi-Maesano I, NguyenLT, Bocage AS, Bedu M, Caillaud D. Interrelationships among asthma, atopy, rhinitis and exhaled nitric oxide in a population based sample of children. Clin Exp Allergy. 2003;33:1506‑11.

92. Zhao Z, Huang C, Zhang X, Xu F, Kan H, Song W, et al. Fractional exhaled nitric oxide in Chinese children with asthma and allergies – a two-city study. Respir Med. 2013;107:161‑71.

93. de Groot EP, Nijkamp A, Duiverman EJ, Brand PL. Allergic rhinitis is associated with poor asthma control in children with asthma. Thorax. 2012;67:582‑7.

94. Lasmar LM, Camargos PA, Ordones AB, Gaspar GR, Campos EG, Ribeiro GA. Prevalence of allergic rhinitis and its impact on the use of emergency care services in a group of children and adolescents with moderate to severe persistent asthma. J Pediatr (Rio J). 2007;83(6):555‑61.

95. Deliu M, Belgrave D, Simpson A, Murray CS, Kerry G, Custovic A. Impact of rhinitis on asthma severity in school-age children Allergy. 2014;69(11):1515‑21.

96. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic rhinitisand its Impact on Asthma (ARIA) 2008 update. Allergy. 2008;63(Suppl 86):8-160.

97. Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology. 2012;50(1):1-12.

98. Stevens WW, Peters AT, Hirsch GA, Nordberg C, Schwartz BS, Dione Mercer D, et al. Clinical characteristics of patients with chronic rhinosinusitis with nasal polyps, asthma, and aspirin exacerbated respiratory disease. J Allergy Clin Immunol Pract. 2017;5(4):1061‑70.

99. Joe SA, Thakkar K. Chronic rhinosinusitis and asthma. Otolaryngol Clin N Am. 2008;41:297-309.

100. Pearlman AN, Chandra RK, Chang D, Conley DB, Tripathi-Peters A, Grammer LC, et al. Relationships between severity of chronic rhinosinusitis and nasal polyposis, asthma, and atopy. Am J Rhinol Allergy. 2009;23:145-8.

101. Chandran S, Higgins T. Pediatric rhinosinusitis: definitions, diagnosis, and management - an overview. Am J Rhinol Allergy. 2013;1(3):16‑9.

102. Sander N. Belief systems that affect the management of childhood asthma. Immunol Allergy Clin N Am. 1998;18(1):99-112.

103. Agrawal S, Singh M, Mathew J, Malhi P. Efficacy of an individualized written homemanagement plan in the control of moderate persistent asthma: a randomized, controlled trial. Acta Paediatr. 2005;94:1742‑6.

104. Ducharme F, Zemek R, Chalut D, McGillivray D, Noya FJ, Resendes S, et al. Written action plan in pediatric emergency room improves asthma prescribing, adherence, and control. Am J Respir Crit Care Med. 2011;183:195‑203.

105. Ghosh S, Hoselton S, Schuh J. Allergic inflammation in Aspergillus fumigatus induced fungal asthma. Curr Allergy Asthma Rep. 2015;15:1‑11.

106. Greenberger PA, Bush RK, Demain JG, Luong A, Slavin RG, Knutsen AP. Allergic bronchopulmonary aspergillosis. J Allergy Clin Immunol Pract. 2014;2(6):703-8.

107. Zhang P, Zein J. Novel insights on sex-related differences in asthma.Curr Allergy Asthma Rep. 2019;19(10):44.

108. Allen DB. Systemic effects of inhaled corticosteroids in children. Curr Opin Pediatr. 2004;16(4):440-4.

109. Bateman ED. Efficacy and safety of high-dose ciclesonide for the treatment of severe asthma Expert Rev Respir Med. 2013;7(4):339‑48.

110. Cavkaytar O, Vuralli D, Yilmaz EA, Buyuktiryaki B, Soyer O, Sahiner UM, et al. Evidence of hypothalamic-pituitary-adrenal axis suppression during moderate-to-high-dose inhaled corticosteroid use. Eur J Pediatr. 2015;174:1421‑31.

111. Anuradha KWDA, Prematilake GLDC, Batuwita BAUI, Kannangoda KASR, Hewagamage US, Wijeratne S, et al. Effect of long term inhaled corticosteroid therapy on adrenal suppression, growth and bone health in children with asthma. BMC Pediatrics. 2019;19:411.

112. Loke YK, Blanco P, Thavarajah M, Wilson AM. Impact of Inhaled Corticosteroids on Growth in Children with Asthma: Systematic Review and Meta-Analysis. PLoS One. 2015 Jul 20;10(7):e0133428.

113. Pruteanu AI, Chauhan BF, Zhang L, Prietsch SO, Ducharme FM. Inhaled corticosteroids in children with persistent asthma: dose-response effects on growth. Evid Based Child Health. 2014;9(4):931-1046.

114. Stelmach I, Olszowiec-Chlebna M, Jerzynska J, Grzelewski T, Stelmach W, Majak P. Inhaled corticosteroids may have a beneficial effect on bone metabolism in newly diagnosed asthmatic children. Pulm Pharmacol Ther. 2011;24(4):414-20.

115. Trinh, HKT, Lee, S, Cao, TBT, Park, HS. Asthma pharmacotherapy: an update on leukotriene treatments. Exp Rev Respir Med. 2019;13(12):1169‑78.

116. Hoshino M, Ohtawa J, Akitsu K, Satoh T. Effect of the addition of montelukast on airway inflammation and remodeling in symptomatic asthma. Eur Respir J. 2017;50:PA4680.

117. Pal K, Feng X, Steinke JW, Borish L. Leukotriene A4 hydrolase activation and leukotriene B4 production by eosinophils in severe asthma. Am J Respir Cell Mol Biol. 2018;60(4):413-9.

118. Evans DJ, Barnes PJ, Spaethe SM, van Alstyne EL, Mitchell MI, O'Connor BJ. Effect of a leukotriene B4 receptor antagonist, LY293111, on allergen induced responses in asthma. Thorax. 1996;51:1178-84.

119. Strunk RC, Bacharier LB, Phillips BR, Szefler SJ, et al. Azitromycin or montelukast as Inhaled Corticosteroid-Sparing Agents in Moderate to Severe Childhood Asthma Study. J Allergy Clin Immunol. 2008;122(6):1138-44.

120. Chauhan BF, Jeyaraman MM, Singh Mann A, Lys J. addition of anti-leukotriene agents to inhaled corticosteroids for adults and adolescentes with persistent asthma. Cochrane Database Syst Rev. 2017; Mar 16;3:CD010347.

121. Hoshino M, Akitsu K, Ohtawa J. Comparison between montelukast and tiotropium as add-on therapy to inhaled corticosteroids plus a long-acting B2-agonist in for patients with asthma. J Asthma. 2019;56(9):995-1003.

122. Bush A. Azithromycin is the answer in Paediatric Respiratory Medicine, but what was the question? Paediatr Respir Rev. 2019; Aug 16. pii: S1526-0542(19)30065-X.

123. Kwong CG, Bacharier LB. Management of asthma in the preschool child. Immunol Allergy Clin N Am. 2019;39:177‑90.

124. Schögler A, Kopf BS, Edwards MR, Johnston SL, Casaulta C, Kieninger E, et al. Novel antiviral properties of azithromycin in cystic fibrosis airway epithelial cells. Eur Respir J. 2015;45:428‑39.

125. Castro-Rodriguez J, Holberg CJ, Wright AL, Martinez FD. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med. 2000;162(4):1403‑6.

126. Guilbert TW, Morgan WJ, Krawiec M, Lemanske RF Jr, Sorkness C, Szefler SJ, et al. The prevention of early asthma in kids study: design, rationale and methods for the childhood asthma research and education network. Control Clin Trials. 2004;25(3):286‑310.

127. Bacharier LB, Guilbert TW, Mauger DT, Boehmer S, Beigelman A, Fitzpatrick AM, et al. Early administration of azithromycin and prevention of severe lower respiratory tract illnesses in preschool children with a history of such illnesses: a randomized clinical trial. JAMA. 2015;314:2034‑44.

128. Stokholm J, Chawes BL, Vissing NH, Bjarnadóttir E, Pedersen TM, Vinding RK, et al. Azithromycin for episodes with asthmalike symptoms in young children aged 1-3 years: a randomised, double-blind, placebo-controlled trial. Lancet Respir Med. 2016;4:19-26.

129. Mandhane PJ, Paredes Zambrano de Silbernagel P, Aung YN, Williamson J, Lee BE, Spier S, et al. Treatment of preschool children presenting to the emergency department with wheeze with azithromycin: A placebo-controlled randomized trial. PLoSOne. 2017;798 12:e0182411.

130. Brusselle GG, Vanderstichele C, Jordens P, Deman R, Slabbynck H, Ringoet V, et al. Azithromycin for prevention of exacerbations in severe asthma (AZISAST): a multicentrerandomised double-blind placebo-controlled trial. Thorax. 2013;68(4):322-9.

131. Gibson PG, Yang IA, Upham JW, Reynolds PN, Hodge S, James AL, et al. Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES): a randomised, double-blind, placebo-controlled trial. Lancet. 2017;390(10095):659-68.

132. Hahn DL, Grasmick M, Hetzel S, Yale S, Group AS. Azithromycin for bronchial asthma in adults: an effectiveness trial. J Am Board Fam Med. 2012;25(4):442-59.

133. Sutherland ER, King TS, Icitovic N, Ameredes BT, Bleecker E, Boushey HA, et al. A trial of clarithromycin for the treatment of suboptimally controlled asthma. J Allergy Clin Immunol. 2010;126(4):747-53.

134. Simpson JL, Powell H, Boyle MJ, Scott RJ, Gibson PG. Clarithromycin targets neutrophilic airway inflammation in refractory asthma. Am J Respir Crit Care Med. 2008;177(2):148‑55.

135. Holguin F, Cardet JC, Chung KF, Diver S, Ferreira DS, Fitzpatrick A, et al. Management of Severe Asthma: a European Respiratory Society/American Thoracic Society Guideline. Eur Respir J.2020 Jan 2;55(1).pii: 1900588.

136. Taylor SL, Leong LEX, Mobegi FM, Choo JM, Wesselingh S, Yang IA, et al. Long-Term Azithromycin Reduces Haemophilus influenzae and Increases Antibiotic Resistance in Severe Asthma. Am J Respir Crit Care Med. 2019;200(3):309-17.

137. Haselkorn T, Fish JE, Zeiger RS, Szefler SJ, Miller DP, Chipps BE, et al. Consistently very poorly controlled asthma as defined by impairment domain of the Expert Panel Report 3 guidelines, increases risk for future severe asthma exacerbations in The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study. J Allergy Clin Immunol. 2009;124:895-902.

138. Zhou EH, Kang EM, Seymour S, Iyasu S. Long-acting beta2- adrenergic agonist in pediatric and adolescent asthma patients, 2003-2011. J Asthma. 2014;51(10):1061-7.

139. Kew KM, Karner C, Mindus SM, Ferrara G. Combination formoterol and budesonide as maintenance and reliever therapy versus combination inhaler maintenance for chronic asthma in adults and children. Cochrane Database Syst Rev. 2013;(12):CD009019.

140. Cates CJ, Karner C. Combination formoterol and budesonide as maintenance and reliever therapy versus current best practice (including inhaled steroid maintenance), for chronic asthma in adults and children. Cochrane Database Syst Rev. 2013;(4):CD007313.

141. Chauhan BF, Chartrand C, Ni Chroinin M, Milan SJ, Ducharme FM. Addition of long-acting beta2-agonists to inhaled corticosteroids for chronic asthma in children. Cochrane Database Syst Rev. 2015;(11):CD007949.

142. Lin J, Zhou X, Wang C, Liu C, Cai S, Huang M. Symbicort® Maintenance and Reliever Therapy (SMART) and the evolution of asthma management within the GINA guidelines. Exp Rev Respir Med. 2018;12(3):191-202.

143. Jorup C, Lythgoe D, Bisgaard H. Budesonide/formoterol maintenance and reliever therapy in adolescent patients with asthma. Eur Respir J. 2018;51(1). pii:1701688.

144. Brometo de tiotrópio [Internet]. Disponivel em: https://consultaremedios.com.br/brometo-de-tiotropio/bula. Acessado em: 19/12/2019.

145. Murphy KR, Chipps BE. Tiotropium in children and adolescents with asthma. Ann Allergy Asthma Immunol. 2020;124(3):267‑76 e3.

146. Mansfield L, Duong-Quy S, Craig T. Burden of asthma and role of

2.5 µg Tiotropium Respimat as an add-on therapy: a systematic review of phase 2/3 trials. Adv Ther. 2019;36:2587-99.

147. Humbert M, Busse W, Hanania NA, Lowe PJ, Canvin J, Erpenbeck VJ, et al. Omalizumab in asthma: an update on recent developments. J Allergy Clin Immunol Pract. 2014;2:525-36.

148. Alhossan A, Lee CS, MacDonald K, Abraham I. “Real-life” effectiveness studies of omalizumab in adult patients with severe allergic asthma: metaanalysis. J Allergy Clin Immunol Pract. 2017;5:1362-70.

149. Chipps BE, Lanier B, Milgrom H, Deschildre A, Hedlin G, Szefler SJ et al. Omalizumab in children with uncontrolled allergic asthma: Review of clinical trial and real-world experience. J Allergy Clin Immunol. 2017;139:1431-44.

150. Licari A, Marseglia A, Caimmi S, Castagnoli R, Foiadelli T, Salvatore B, et al. Omalizumab in Children. Pediatr Drugs. 2014;16:491‑502.

151. Corren J, Kavati A, Ortiz B, Colby JA, Ruiz K, Maiese BA, et al. Efficacy and safety of omalizumab in children and adolescents with moderate-to-severe asthma: A systematic literature review. Allergy Asthma Proc. 2017;38:250‑63.

152. Krings JG, McGregor MC, Bacharier LB, Castro M. Biologics for severe asthma: treatment-specific effects are important in choosing a specific agent. J Allergy Clin Immunol Pract. 2019;7:1379-92.

153. Teach SJ, Gill MA, Togias A, Sorkness CA, Arbes Jr SJ, Calatroni A, et al. Preseasonal treatment with either omalizumab or an inhaled corticosteroid boost to prevent fall asthma exacerbations. J Allergy Clin Immunol. 2015;136:1476-85.

154. Normansell R, Walker S, Milan SJ, Walters EH, Nair P. Omalizumab for asthma in adults and children. Cochrane Database Syst Rev. 2014;1:CD003559.

155. Casale TB, Chipps BE, Rosen K, Trzaskoma B, Haselkorn T, Omachi TA, et al. Response to omalizumab using patient enrichment criteria from trials of novel biologics in asthma. Allergy. 2018;73:490-7.

156. Chong Neto HJ, Solé D, Rosário NA, Sarinho EC, Chong-Silva DC, Kiertsman B, et al. Diretrizes da Associação Brasileira de Alergia e Imunologia e Sociedade Brasileira de Pediatria para sibilância e asma no pré-escolar. Arq Asma Alerg Imunol. 2018;2:163-208.

157. Bousquet J, Chanez P, Lacoste JY, Barneon G, Ghavanian N, Enander I, et al. Eosinophilic Inflammation in Asthma. N Engl J Med. 1990;323:1033-9.

158. Menzies-Gow A, Robinson DS. Eosinophils, eosinophilic cytokines (interleukin-5), and antieosinophilic therapy in asthma. Curr Opin Pulm Med. 2002;8:33-8.

159. Robinson DS, Ying S, Bentley AM, Meng Q, North J, Durham SR, et al. Relationships among numbers of bronchoalveolar lavage cells expressing messenger ribonucleic acid for cytokines, asthma symptoms, and airway methacholine responsiveness in atopic asthma. J Allergy Clin Immunol. 1993;92:397-403.

160. Smith DA, Minthorn EA, Beerahee M. Pharmacokinetics and pharmacodynamics of mepolizumab, an anti-interleukin-5 monoclonal antibody. Clin Pharmacokinet. 2011;50(4):215-27.

161. Gnanakumaran G, Babu KS. Technology evaluation: mepolizumab, GlaxoSmithKline. Curr Opin Mol Ther. 2003;5(3):321-5.

162. Molfino NA, Gossage D, Kolbeck R, Parker JM, Geba GP.Molecular and clinical rationale for therapeutic targeting of interleukin-5 and its receptor. Clin Exp Allergy. 2012;42(5):712-37.

163. Ortega HG, Yancey SW, Mayer B, Gunsoy NB, Keene ON, Bleecker ER, et al. Severe eosinophilic asthma treated with mepolizumab stratified by baseline eosinophil thresholds: a secondary analysis of the DREAM and MENSA studies. Lancet Respir Med. 2016;4(7):549-56.

164. Cardet JC, Israel E. Update on reslizumab for eosinophilic asthma. Expert Opin Biol Ther. 2015;15:1531-9.

165. Wandalsen GF, Sano F, Falcão ACA, Machado AS, Serpa FS, Rizzo JA, et al. Guia para o manejo da asma grave – 2019 – Associação Brasileira de Alergia e Imunologia. Arq Asma Alerg Imunol. 2019;3(4):337-62.

166. 125526 Mepolizumab Statistical PREA – FDA [Internet]. Disponívelem: www.fda.gov/media/95129/download . Acessado em: junho/2019.

167. Pouliquen IJ, Kornmann O, Barton SV, Price JA, Ortega HG. Characterization of the relationship between dose and blood eosinophil response following subcutaneous administration of mepolizumab. Int J Clin Pharmacol Ther. 2015;53(12):1015‑27.

168. Matucci A, Vultaggio A, Danesi R. The use of intravenous versus subcutaneous monoclonal antibodies in the treatment of severe asthma: a review. Respir Res. 2018;19:154.

169. Ortega HG, Liu MC, Pavord ID, Brusselle GG, FitzGerald JM, Chetta A, et al. Mepolizumab treatment in patients with severe eosinophilic asthma. N Engl J Med. 2014;371:1198-207.

170. Giallongo A, Parisi GF, Licari A, Pulvirenti G, Cuppari C, Salpietro C, et al. Novel therapeutic targets for allergic airway disease in children. Drugs Context. 2019 Jul 9;8:212590.

171. Rabe KF, Nair P, Brusselle G, Maspero JF, Castro M, Sher L, et al. Efficacy and safety of dupilumab in glucocorticoid-dependent severe asthma. N Engl J Med. 2018;378:2475‑85.

172. Castro M, Corren J, Pavord ID, Maspero J, Wenzel S, Rabe KF, et al. Dupilumab efficacy and safety in moderate-to-severe uncontrolled asthma. N Engl J Med. 2018;378:2486‑96.

173. FDA Approved Drug Products. Dupilumab [Internet]. Disponível em: https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&varApplNo=761055. Acessado em: 01/04/2019.

174. European Medicines Agency. Dupixent [Internet]. Disponível em:https://www.ema.europa.eu/en/medicines/human/summariesopinion/dupixent. Acessado em: 01/04/2019.

175. Clinical Trials.gov. Assessment of the safety and efficacy of dupilumab in children with asthma (liberty asthma excursion) [Internet]. Disponível em: https://clinicaltrials.gov/ct2/show/NCT03560466. Acessado em: 01/04/2019.

176. Clinical Trials.gov. Safety and Efficacy of CRD007 in Adult Asthma Subjects [Internet]. Disponível em: https://clinicaltrials.gov/ct2/show/NCT02615080. Acessado em: 01/04/2019.

177. Giembycz MA. Can the anti-inflammatory potential of PDE4 inhibitors be realized: guarded optimism or wishful thinking? Br J Pharmacol. 2008;155;288‑90.

178. Clinical Trials. gov. Pilot Study of Tetomilast in Chronic Obstructive Pulmonary Disease (COPD) Associated With Emphysema (EMPHASIS) [Internet]. Disponível em: https://clinicaltrials.gov/ct2/show/NCT00874497. Acessado em: 02/04/2019.

179. Hogan AD, Bernstein JA. GINA Updated 2019: Landmark changes recommended for asthma management. Ann Allergy Asthma Immunol. 2019; Nov 14. pii: S1081-1206(19)31385-7.

180. Sanchis J, Corrigan C, Levy ML, Viejo JL, ADMIT Group. Inhaler devices-from theory to practice. Respir Med. 2013;107(4):495‑502.

181. Heyder J, Gebhart F, Rudolf G, Schiller C F, Stahlhofen W. Deposition of particles in the human respiratory tract in the size range 0.005-15 μm. J Aerosol Sci. 1986;17:811-25.

182. Broeders ME, Sanchis J, Levy ML, Crompton GK, Dekhuijzen PN; ADMIT Working Group. The ADMIT series-issues in inhalation therapy. 2. Improving technique and clinical effectiveness. Prim Care Respir J. 2009;18(2):76-82.

183. Lewis RM, Fink JB. Promoting adherence to inhaled therapy: building partnerships through patient education. Respir Care Clin N Am. 2001;7(2):277-301.

184. Dolovich M, Ahrens R, Hess D, Anderson P, Dhand R, Rau J, et al. Device selection and outcomes of aerosol therapy: Evidencebased guidelines: American College of Chest Physicians/ American College of Asthma, Allergy and Immunology. Chest. 2005;127:335‑71.

185. Pereira LF. Dispositivos para uso de aerossóis. In: Pereira CA, ed. Medicina Respiratória, 2ª ed. São Paulo: Atheneu; 2012.

186. World Confederation of Physical Therapy (WCPT) [Internet]. Disponível em: https://www.wcpt.org/policy/ps-descriptionPT. Acessado em: 10/12/2019.

187. Armstrong M, Vogiatzis I. Personalized exercise training in chronic lung diseases. Respirology. 2019;24(9):854-62.

188. Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, et al. ATS/ERS Task Force on Pulmonary Rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188(8):e13-64.

189. World Health Organization (WHO) (2015) Physical activity and young people. WHO. World Health Organization [Internet]. Disponível em: https://www.who.int/dietphysicalactivity/factsheet_young_people/en/ . Acessado em 10/12/2019.

190. Bhagat D, Fagnano M, Halterman JS, Reznik M. Asthma symptoms, interactive physical play and behavioral and academic outcomes in urban children with persistent asthma. J Asthma. 2019;56(7):711‑8.

191. Lochte L, Nielsen KG, Petersen PE, Platts-Mills TA. Childhood asthma and physical activity: a systematic review with metaanalysis and Graphic Appraisal Tool for Epidemiology assessment. BMC Pediatr. 2016;16:50.

192. Reimberg MM, Pachi JRS, Scalco RS, Serra AJ, Fernandes L, Politti F, et al. Patients with asthma have reduced functional capacity and sedentary behavior. J Pediatr (Rio J). 2018. pii: S0021-7557(18)30555-2.

193. Villa F, Castro AP, Pastorino AC, Santarém JM, Martins MA, Jacob CM, et al. Aerobic capacity and skeletal muscle function in children with asthma. Arch Dis Child. 2011;96(6):554-9.

194. van der Kamp MR, Thio BJ, Tabak M, Hermens HJ, Driessen J, van der Palen J. Does exercise-induced bronchoconstriction affect physical activity patterns in asthmatic children? J Child Health Care. 2019 Oct 13:1367493519881257.

195. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee I-M, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43:1334‑59.

196. Schultz K, Seidl H, Jelusic D, Wagner R, Wittmann M, Faller H, et al. Effectiveness of pulmonary rehabilitation for patients with asthma: study protocol of a randomized controlled trial (EPRA). BMC Pulm Med. 2017;17(1):49.

197. Reimberg MM, Castro RA, Selman JP, Meneses AS, Politti F, Mallozi MC, et al. Effects of a pulmonary rehabilitation program on physical capacity, peripheral muscle function and inflammatory markers in asthmatic children and adolescents: study protocol for a randomized controlled trial. Trials. 2015;16:346.

198. Ahmaidi SB, Varray AL, Savy-Pacaux AM, Prefaut CG. Cardiorespiratory fitness evaluation by the shuttle test in asthmatic subjects during aerobic training. Chest. 1993;103:1135‑41.

199. Andrade LB, Britto MC, Lucena-Silva N, Gomes RG, Figueroa JN.The efficacy of aerobic training in improving the inflammatory component of asthmatic children. Randomized trial. Respir Med. 2014;108:1438‑45.

200. Basaran S, Guler-Uysal F, Ergen N, Seydaoglu G, Bingol-Karakoç G, Ufuk Altintas D. Effects of physical exercise on quality of life, exercise capacity and pulmonary function in children with asthma. J Rehabil Med. 2006;38:130‑5.

201. Neder JA, Nery LE, Silva AC, Cabral AL, Fernandes AL. Short-term effects of aerobic training in the clinical management of moderate to severe asthma in children. Thorax. 1999;54(3):202-6.

202. França-Pinto A, Mendes FA, de Carvalho-Pinto RM, Agondi RC, Cukier A, Stelmach R, et al. Aerobic training decreases bronchial hyperresponsiveness and systemic inflammation in patients with moderate or severe asthma: a randomised controlled trial. Thorax. 2015;70(8):732-9.

203. Wanrooij VH, Willeboordse M, Dompeling E, van de Kant KD. Exercise training in children with asthma: a systematic review. Br J Sports Med. 2014;48(13):1024-31.

204. Joschtel B, Gomersall SR, Tweedy S, Petsky H, Chang AB, Trost SG. Effects of exercise training on physical and psychosocial health in children with chronic respiratory disease: a systematic review and meta-analysis. BMJ Open Sport Exerc Med. 2018;4(1):e000409.

205. Whelan MA, Hwan WH, Shaffer T, Padman R, Cox T, Oldham H, et al. Efficacy of chest physiotherapy (CPT) in pediatric patients with acute asthma exacerbations. Pediatr Asthma Allergy Immunol. 2009; 22(2):69-74.

206. Macedo TM, Freitas DA, Chaves GS, Holloway EA, Mendonça KM. Breathing exercises for children with asthma. Cochrane Database Syst Rev. 2016 Apr 12;4:CD011017. doi: 10.1002/14651858.CD011017.pub2.

207. Manual dos Centros de Referência para Imunobiológicos Especiais. Ministério da Saúde do Brasil. 5ª ed. Disponível em: http://portalarquivos2.saude.gov.br/images/pdf/2014/dezembro/09/manual-cries-9dez14-web.pdf. Acessado em: 16/12/2019.

208. Moreno D, Barroso J, Garcia A. Vaccines for Patients with COPD. Recent Pat Inflamm Allergy Drug Discov. 2015;9:23-30.

209. Corrêa RA, José BPS, Malta DC, Passos VMA, França EB, Teixeira RA, et al. Burden of disease by lower respiratory tract infections in Brazil, 1990 to 2015: estimates of the Global Burden of Diseases 2015 study. Rev Bras Epidemiol. 2017;20(1):171-81.

210. Froes F, Roche N, Blasi F. Pneumococcal vaccination and chronic respiratory diseases. Int J Chron Obstruct Pulmon Dis. 2017;12:3457-68.

211. Kfouri RA, Marano SB. Influenza. In: Amato Neto V (ed.). Atualizações, orientações e sugestões sobre imunizações. São Paulo: Segmento Farma; 2011. p. 297-310.

212. Grohskopf LA, Alyanak E, Broder KR, Walter EB, Fry AM, Jernigan DB. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices – United States, 2019-20 Influenza Season. MMWR Recomm Rep. 2019;68(3):1-21.

213. Morris DE, Cleary DW, Clarke SC. Secondary bacterial infections associated with influenza pandemics. Front Microbiol. 2017;8:1041.

214. Kopsaftis Z, Wood-Baker R, Poole P. Influenza vaccine for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev. 2018; issue 6. Art. No.: CD002733.

215. Tisa V, Barberis I, Faccio V, Paganino C, Trucchi C, Martini M, et al. Quadrivalent influenza vaccine: A new opportunity to reduce the influenza burden. J Prev Med Hyg. 2016;57:E28‑33.

216. Informe Técnico 21ª Campanha Nacional de Vacinação contra a Influenza. Secretaria de Vigilância em Saúde (SVS) - Ministério da Saúde do Brasil. Disponível em: http://portalarquivos2.saude.gov.br/images/pdf/2019/marco/01/Informe-Cp-Influenza-29-02-2019-final.pdf. Acessado em: 16/12/2019.

217. Torres A, Blasi F, Dartois N, Akova M. Which individuals are at increased risk of pneumococcal disease and why? Impact of COPD, asthma, smoking, diabetes, and/or chronic heart disease on community-acquired pneumonia and invasive pneumococcal disease. Thorax. 2015;70(10):984‑9.

218. Klemets P, Lyytikäinen O, Ruutu P, Ollgren J, Kaijalainen T, Leinonen M, et al. Risk of invasive pneumococcal infections among working age adults with asthma. Thorax. 2010; 65(8):698-702.

219. Vacina Pneumocócica 10 Valente (conjugada). Bula do produto [Internet]. Disponível em: http://www.anvisa.gov.br/datavisa/fila_bula/frmVisualizarBula.asp?pNuTransacao=13177362016&pIdAnexo=3137117 . Acessado em: 16/12/2019.

220. Vacina Pneumocócica 13 Valente (conjugada). Bula do produto [Internet]. Disponível em: http://www.anvisa.gov.br/datavisa/fila_bula/frmVisualizarBula.asp?pNuTransacao=10025292013&pIdAnexo=1881834. Acessado em: 16/12/2019.

221. Golos M, Eliakim-Raz N, Stern A, Leibovici L, Paul M. Conjugated pneumococcal vaccine versus polysaccharide pneumococcal vaccine for prevention of pneumonia and invasive pneumococcal disease in immunocompetent and immunocompromised adults and children. Cochrane Database Syst Rev. 2016; Issue 8. Art. No: CD012306.

222. Pneumologia. Guia de Imunização SBIm/SBPT 2018/2019 [Internet]. Disponível em: https://sbim.org.br/images/files/guiapneumologia-sbim-2018-2019.pdf. Acessado em: 16/12/2019.

223. Pneumovax 23. Bula do produto [Internet]. Disponível em: http://www.anvisa.gov.br/datavisa/fila_bula/frmVisualizarBula.asp?pNuTransacao=15393712016&pIdAnexo=3304945. Acessado em: 26/05/2019.

224. Calendários de Vacinação SBIm. Pacientes Especiais [Internet]. Disponível em: https://sbim.org.br/images/calendarios/calendsbim-pacientes-especiais.pdf. Acessado em: 16/12/2019.

225. Agrawal A, Murphy TF. Haemophilus influenzae infections in the H influenzae type b conjugate vaccine era. J Clin Microbiol. 2011;49(11):3728‑32.

226. Centers for Disease Control and Prevention (CDC). Burden and Prevention of Influenza and Pertussis Among Pregnant Women and Infants – United States. Weekly / October 11, 2019 / 68(40);885‑92.

227. Capili CR, Hettinger A, Rigelman-Hedberg N, Fink L, Boyce T, Lahr B, et al. Increased risk of pertussis in patients with asthma. J Allergy Clin Immunol. 2012;129:957‑63.

228. Calendário de Vacinação da SBP 2019 [Internet]. Disponível em: https://www.sbp.com.br/fileadmin/user_upload/21273o-DocCientCalendario_Vacinacao_2019.pdf. Acessado em 16/12/2019.

229. World Health Organization (WHO). Pertussis vaccine. WHO Position Paper. 28 August 2015, 90th Year. No. 35, 2015, 90, 433‑60.

230. Petraglia T. Vacinação de pacientes com comorbidades e seus contactantes. In: Ballalai I. Manual prático de imunizações. São Paulo: AC Farmacêutica; 2013.


Submetido em:
06/01/2020

Aceito em:
15/01/2020

6a159582a953954c5436db43 aaai Articles
Links & Downloads

Arq Asma Alerg Imunol

Share this page
Page Sections