谢谢——是舒利迭 O(∩_∩)O~

12.哮喘病能治愈吗？怎样判断哮喘已治愈
许多哮喘病人经常向医生提出这样一个问题：“我的病能治好吗？”实际上这个问题对于仅给您看过1-2次病的医生是很难回答的。众所周知，哮喘病是一种很容易复发的慢性疾病，虽然经过一段时间的合理治疗，症状可以完全消失，数月甚至更长的时间内不发作，但这并不意味已经治愈了，只能认为是哮喘的缓解期，医生最初给您的治疗方针就是让您的病情尽量少发作、让您的缓解期尽量延长。医生给您制定了一项长期的缓解期治疗方法，按照此方案经过一段时间的系统而正规的治疗后，您每次哮喘发作的间隔时间可以明显延长，可能有数月甚至1-2年的缓解期，许多病人此时往往易误码率认为自己的病已经治好而放弃治疗，这是不对的，也是很可惜的，目前一般认为，哮喘的缓解期达3年以上，结合医生给您作的气道反应性检查恢复正常，就可以认为是哮喘病临床治愈，在达到这个标准之前，您应应该继续配合医生治疗，持之以恒，并配合积极的预防措施，才能达到最佳疗效。但是由于哮喘病人的过敏性素质往往是遗传的，难以治愈，所以即使哮喘病达到临床治疗的标准，仍应采取相应的预防措施，以免再发。


你可以去做全面的肺功能检查，看看是否还存在气道高反应性，肺活量和 呼气峰流速等值。

长期治疗3年以上，持之以恒，加以预防，永不复发

楼主，看看以下FDA关于舒利迭的警告的原文，建议楼主不要为药厂宣传的这个视频置顶了，以免误导广大哮喘患者。
FDA Drug Safety Communication: New safety requirements for long-acting inhaled asthma medications called Long-Acting Beta-Agonists (LABAs)
Safety Announcement
Additional Information for Patients
Additional Information for Healthcare Professionals
FDA Approved Medications Containing a Long-Acting Beta Agonist (LABA)
Data Summary
Safety Announcement
[02-18-2010] Due to safety concerns, the U.S. Food and Drug Administration (FDA) is requiring changes to how long-acting inhaled medications called Long-Acting Beta-Agonists (LABAs) are used in the treatment of asthma. These changes are based on FDA's analyses of studies showing an increased risk of severe exacerbation of asthma sympto***eading to hospitalizations in pediatric and adult patients as well as death in some patients using LABAs for the treatment of asthma (see Data Summary below).
LABAs are approved as single-ingredient products (Serevent and Foradil) and as an ingredient in combination products containing inhaled corticosteroids (Advair and Symbicort) for the treatment of asthma and chronic obstructive pulmonary disease (COPD). They work by relaxing muscles in the airway and lungs. This helps patients breathe easier, and lessens symptoms such as wheezing and shortness of breath. The new recommendations only apply to the use of LABAs in the treatment of asthma.
To ensure the safe use of these products:
The use of LABAs is contraindicated without the use of an asthma controller medication such as an inhaled corticosteroid. Single-ingredient LABAs should only be used in combination with an asthma controller medication; they should not be used alone.
LABAs should only be used long-term in patients whose asthma cannot be adequately controlled on asthma controller medications.
LABAs should be used for the shortest duration of time required to achieve control of asthma symptoms and discontinued, if possible, once asthma control is achieved. Patients should then be maintained on an asthma controller medication.
Pediatric and adolescent patients who require the addition of a LABA to an inhaled corticosteroid should use a combination product containing both an inhaled corticosteroid and a LABA, to ensure compliance with both medications.
FDA is also requiring a risk management program called a Risk Evaluation and Mitigation Strategy (REMS) for these products. The REMS for LABAs will include a revised Medication Guide written specifically for patients, and a plan to educate healthcare professionals about the appropriate use of LABAs. In addition, FDA is requiring the manufacturers to conduct additional clinical trials to further evaluate the safety of LABAs when used in combination with inhaled corticosteroids. FDA will seek input on these studies at a public advisory committee meeting1 on March 10-11, 2010.
FDA has determined that the benefits of LABAs in improving asthma symptoms outweigh the potential risks when used appropriately with an asthma controller medication in patients who need the addition of LABAs. FDA believes the safety measures recommended above will improve the safe use of these drugs.


Additional Information for Patients
Long-Acting Beta Agonists (LABAs) do not relieve sudden-onset asthma symptoms. Patients should always have a rescue inhaler, such as an albuterol inhaler, to treat sudden onset asthma sympto***ABAs must never be taken alone for the treatment of asthma.
Patients who need a LABA plus an asthma controller medication that is not available as a combination product should work with their healthcare professionals to ensure that each individual medication is taken correctly.
Patients should read the Medication Guide for LABAs.
Patients should talk with their healthcare professional to learn the warning signs of worsening asthma.
Patients should discuss any questions they have about the use of LABAs with their healthcare professional.
Additional Information for Healthcare Professionals
Long-Acting Beta Agonists (LABAs) should not be started in patients with acutely deteriorating asthma.
Discuss with patients and families the warning signs of worsening asthma and advise them to seek immediate medical attention should their condition deteriorate.
LABAs do not relieve sudden-onset asthma symptoms. A rescue inhaler, such as an albuterol inhaler, should be prescribed to treat sudden asthma symptoms.
Encourage patients, families, and caregivers to read the Medication Guide that accompanies LABA prescriptions.
When possible, prescribe a combination inhaled corticosteroid – LABA product to pediatric and adolescent patients who need the addition of a LABA for better control of their asthma. Using a combination product will help ensure compliance with both of these medications.
FDA Approved Medications Containing a Long-Acting Beta Agonist (LABA)
Brand Name LABA active ingredient Corticosteroid active ingredient FDA Approved Uses   
Serevent Diskus Salmeterol None Asthma, COPD,
exercise-induced bronchospasm
Foradil Aerolizer Formoterol None Asthma, COPD, exercise-induced bronchospasm
Foradil Certihaler* Formoterol None Asthma
Advair Diskus Salmeterol Fluticasone Asthma, COPD
Advair HFA Salmeterol Fluticasone Asthma
Symbicort Formoterol Budesonide Asthma, COPD
Brovana Arformoterol None COPD
Perforomist Formoterol None COPD
* not currently marketed in the U.S.
Data Summary
FDA's decision to require a Risk Evaluation and Mitigation Strategy (REMS) and class-labeling changes to the drug labels for Long-Acting Beta Agonists (LABAs) is based on analyses from the Salmeterol Multi-center Asthma Research Trial (SMART), the Salmeterol Nationwide Surveillance study (SNS), and a meta-analysis conducted by FDA in 2008 and discussed at the joint Pulmonary Allergy Drugs, Drug Safety and Risk Management, and Pediatric Advisory Committees, held on December 10-11, 2008 (for complete safety reviews and background information discussed at this meeting see the following link: December 10-11 2008 AC meeting2).
SMART was a large, randomized, 28-week, placebo-controlled trial that evaluated patients 12 years of age and older receiving standard asthma therapy and the addition of either salmeterol or placebo. A total of 26,355 patients were evaluated in this study. Results showed that patients receiving salmeterol were at an increased risk for asthma-related death compared to patients receiving placebo. Subgroup analyses were also performed and found that asthma-related death in Caucasians and African Americans occurred at a higher rate in patients using salmeterol compared to placebo. See Table 1 below for results from SMART.


Table 1. SMART Results
SMART Patients Asthma-Related Deaths in Salmeterol Group
n (%*) Asthma-Related
Deaths in
Placebo Group
n (%*) Relative Risk of Asthma-Related Death
(95% Confidence Interval) Excess Deaths Expressed per 10,000 Patients+
(95% Confidence Interval)
All Patients§
salmeterol: n = 13,176
placebo: n = 13,179 13 (0.10%) 3 (0.02%) 4.37 (1.25, 15.34) 8 (3, 13)
Caucasian Patients
Salmeterol: n = 9,281
Placebo: n = 9,361 6 (0.07%) 1 (0.01%) 5.82 (0.70, 48.37) 6 (1, 10)
African American Patients
Salmeterol: n = 2,366
Placebo: n = 2,319 7 (0.31%) 1 (0.04%) 7.26 (0.89, 58.94) 27 (8, 46)
* 28＆#8209;week estimate, adjusted according to actual lengths of exposure to study treatment to account for early withdrawal of patients from the study.
+ Estimate of the number of additional asthma＆#8209;related deaths in patients treated with salmeterol in SMART, assuming 10,000 patients received salmeterol for a 28＆#8209;week treatment period. Estimate calculated as the difference between the salmeterol and placebo groups in the rates of asthma-related death multiplied by 10,000.
§ The Total Population includes Caucasian, African American, Hispanic, Asian, and Other and not reported. No asthma＆#8209;related deaths occurred in the Hispanic (salmeterol n = 996, placebo n = 999), Asian (salmeterol n = 173, placebo n = 149), or Other (salmeterol n = 230, placebo n = 224) subpopulations. One asthma＆#8209;related death occurred in the placebo group in the subpopulation whose ethnic origin was not reported (salmeterol n = 130, placebo n = 127).
The SNS was a 16-week, double-blind study that compared the addition of salmeterol or albuterol to standard asthma therapy in 25,180 asthma patients who were 12 years of age and older. In the study, there was an increase in the number of respiratory and asthma-related deaths in the salmeterol group (0.07% [12 out of 16,787 patients]) compared to the albuterol group (0.02% [2 out of 8,393 patients] relative risk of 3.0, p=0.105).
In preparation for the December 2008 Advisory Committee, FDA conducted a meta-analysis of 110 studies evaluating the use of LABAs in 60,954 patients with asthma. The meta-analysis used a composite endpoint to measure severe exacerbation of asthma symptoms (asthma-related death, intubation, and hospitalization). The results of the meta-analysis suggested an increased risk for severe exacerbation of asthma symptoms in patients using LABAs compared to those not using LABAs. The largest risk difference per 1000 treated patients was seen in children 4-11 years of age, see table 2 below. The results of the meta-analysis were primarily driven by asthma-related hospitalizations. Other meta-analyses evaluating the safety of LABAs in the treatment of asthma have not shown a significant increase in the risk for severe asthma exacerbations.
Table 2. Meta-Analysis Results: Number of Patients Experiencing an Event*
Patient Population LABA Patients experiencing an event Non-LABA Patients experiencing an event Risk Difference Estimate per 1000 treated patients 95% Confidence Interval


All Patients
n = 30,148 LABA patients
n = 30,806 non-LABA patients    381    304    2.80    1.11 – 4.49
Patients ages 12 to 17 years
n = 3,103 LABA patients
n = 3,289 non-LABA patients    48    30    5.57    0.21 – 10.92
Patients ages 4 to 11 years
n = 1,626 LABA patients
n = 1,789 non-LABA patients    61    39    14.83    3.24 – 26.43
* Event defined as the composite endpoint (asthma-related death, intubation, and hospitalization)
At this time, there are insufficient data to conclude whether using LABAs with an inhaled corticosteroid reduces or eliminates the risk of asthma-related death and hospitalizations. FDA is requiring the manufacturers of LABAs to conduct studies evaluating the safety of LABAs when used in conjunction with an inhaled corticosteroid.
Based on the available information, FDA concludes there is an increased risk for severe exacerbation of asthma sympto***eading to hospitalizations in pediatric and adult patients as well as death in some patients using LABAs for the treatment of asthma. The agency is requiring the REMS and class-labeling changes to improve the safe use of these products.
     Questions and Answers: New Safety Requirements for Long-Acting Asthma Medications called Long-Acting Beta Agonists (LABAs)
Issued 2/18/2010
Q1. What is FDA announcing today?
Q2. Why do people use LABAs?
Q3. Why is FDA requiring LABA manufacturers to have a risk management program for these medicines?
Q4. What is the goal of the new risk management program for LABAs?
Q5. What are the key points people should know about the safe use of LABAs in patients with asthma?
Q6. What are the names of LABA-containing medicines used to treat asthma?
Q7. Why should LABAs only be used with an asthma controller medication, are they safer when used this way?
Q8. If LABAs are to be used with an asthma controller medicine, why aren't all LABA products required by FDA to be in a combination product with an asthma controller medicine?
Q9. Is the use of LABAs without the use of an asthma controller medication a big problem in the treatment of asthma?
Q10. Why is the new risk management program designed for patients with asthma and not for patients with COPD, aren't LABAs used to treat both conditions?
Q11. What information did FDA review to help the Agency decide to require a risk management program?
Q1. What is FDA announcing today?
A. FDA is announcing its recommendations to change how long-acting inhaled medications called Long-Acting Beta-Agonists (or LABAs for short) are used in the treatment of asthma. These changes are based on FDA’s analyses of studies showing an increased risk of severe exacerbation (worsening) of asthma sympto***eading to hospitalization in pediatric and adult patients as well as death in some patients using LABAs for the treatment of asthma. FDA is also requiring a risk management program called a risk evaluation and minimization strategy (REMS) to help ensure the safe use of these products.


Q2. Why do people use LABAs?
A. LABAs are used to help people with asthma or a lung condition called chronic obstructive pulmonary disease (COPD) breathe easier. LABAs are also used for exercise-induced bronchospasm. LABAs improve breathing by relaxing the muscles of the airways to allow more air to flow into and out of the lungs. LABAs are inhaled through the mouth into the lungs using an inhaler or nebulizer device. LABAs are available as single ingredient products, or in combination with a corticosteroid medication. For asthma, LABAs are available by prescription in dry powder inhalers or metered-dose inhalers. LABAs are called long-acting because their effects last for at least 12-hours.
Q3. Why is FDA requiring LABA manufacturers to have a risk management program for these medicines?
A. Despite the benefits of LABAs in helping people with asthma and COPD breathe easier, FDA's analyses indicate there is an increase in the risk of severe exacerbation of asthma symptoms in some patients with asthma that use a LABA compared to patients with asthma that do not use a LABA. Because of this risk, FDA wants to make sure LABAs are used appropriately in patients with asthma. Even though LABAs are approved for use in asthma and COPD, FDA's new recommendations only apply to the use of LABAs in the treatment of asthma. In order to ensure the safe use of these medicines, FDA is requiring the manufacturers of LABAs to develop this risk management program for healthcare professionals and patients.
Q4. What is the goal of the new risk management program for LABAs?
A. The risk management program for LABAs requires the manufacturers to better inform healthcare professionals and patients about the risk of LABAs for patients with asthma and ways to decrease that risk while maintaining the benefits of the drug. Under the program, patients who have a prescription filled for a LABA will receive a revised Medication Guide that explains the risks and benefits of the medicine. In addition manufacturers of LABAs will update the prescribing information they provide to healthcare professionals to include the latest recommendations for safe use of these important medicines.
Q5. What are the key points people should know about the safe use of LABAs in patients with asthma?
A.The key points are:
The use of LABAs is contraindicated without the use of an asthma controller medication such as inhaled corticosteroid. Single-ingredient LABAs should only be used in combination with an asthma controller medication; they should not be used alone.
LABAs should only be used long-term in patients whose asthma cannot be adequately controlled on asthma controller medications.
LABAs should be used for the shortest duration of time required to achieve control of asthma symptoms and discontinued, if possible, once asthma control is achieved. Patients should then be maintained on an asthma controller medication.
Pediatric and adolescent patients who require the addition of a LABA to an inhaled corticosteroid should use a combination product containing both an inhaled corticosteroid and a LABA to ensure compliance with both medications.


Q6. What are the names of LABA-containing medicines used to treat asthma?
A. Below are the names of the LABA-containing medicines approved by FDA to treat asthma:
Brand Name(s) Generic Name(s) Description   
Advair Diskus, Advair HFA salmeterol and fluticasone salmeterol is a LABA and fluticasone is a corticosteroid asthma controller
Symbicort Inhalation Aerosol formoterol and budesonide formoterol is a LABA and budesonide is a corticosteroid asthma controller
Serevent Diskus salmeterol single ingredient LABA with no corticosteroid asthma controller
Foradil Aerolizer formoterol single ingredient LABA with no corticosteroid asthma controller
Q7. Why should LABAs only be used with an asthma controller medication, are they safer when used this way?
A. At this time, there is no conclusive evidence that the combination of an asthma controller medicine with a LABA decreases or eliminates the risk of a LABA. More study and analysis is required in this area. However, because of the risks of LABAs, FDA recommends that a LABA should not be used for a patient whose asthma can be controlled with an asthma controller medicine, such as an inhaled corticosteroid.   If a LABA needs to be added to that medicine, it should only be used until the patient's healthcare professional determines their asthma is under control, and then the LABA should be stopped if possible.   This means it is always necessary for a patient to use a LABA in combination with an asthma controller medication.
As part of today's announcement, FDA is requiring the manufacturers of LABAs to conduct studies evaluating the safety of LABAs when used with an inhaled corticosteroid to better understand this issue.
Q8. If LABAs are to be used with an asthma controller medicine, why aren't all LABA products required by FDA to be in a combination product with an asthma controller medicine?
A. There are several kinds of asthma controller medicines patients may use in combination with a LABA, but not all are able to be made into a combination product. For example, there are many different inhaled corticosteroids available and some pills, such as Singulair (montelukast) or prednisone, which patients may take with a LABA. This means that some single ingredient LABA products need to be available for patients whose other asthma controller medicine cannot be combined in the same inhaled dose. Additionally, single ingredient LABA products are used in the treatment of COPD.
Q9. Is the use of LABAs without the use of an asthma controller medication a big problem in the treatment of asthma?  
A. No, currently, about 95% of patients using a LABA use an inhaled combination product that contains a LABA and a corticosteroid. However, discontinuation of the LABA once control of asthma is achieved is not currently a widespread practice; therefore, many patients who are using a combination LABA product may be unnecessarily exposed to the risks of LABAs. FDA is emphasizing its recommendation that when LABAs are needed that they be used for the shortest time possible to achieve asthma control and then be discontinued, if possible, to limit the long-term use.
Q10. Why is the new risk management program designed for patients with asthma and not for patients with COPD, aren't LABAs used to treat both conditions?
A. LABAs are used to treat both asthma and COPD, however, the studies reviewed by FDA included patients using LABAs for the treatment of asthma. These studies indicated an increased risk of severe exacerbation of asthma sympto***eading to hospitalization and death in these patients. There is no evidence to conclude that people with COPD who use LABAs are at any greater risk compared to people with COPD who do not use LABAs. FDA does not recommend any change in the use of LABAs for COPD.
Q11. What information did FDA review to help the Agency decide to require a risk management program?
A. FDA used a variety of studies and research in patients with asthma using a LABA. Two specific studies that provided valuable information were 1) the Salmeterol Multi-center Asthma Research Trial (SMART) and 2), the Serevent Nationwide Surveillance study (SNS). Salmeterol is the LABA in Serevent. Each of these studies showed a higher risk of death for patients with asthma that used a LABA (salmeterol) compared to patients with asthma that did not use a LABA. In addition, FDA used a research method called a meta-analysis to further understand the risks associated with the use of LABAs in patients with asthma. A meta-analysis uses data from multiple studies on a particular topic to enable scientists to combine information from those studies to make scientific conclusions or recommendations in that area. For more information on these specific studies please see the Drug Safety Communication on New Safety Requirements for LABAs1.