Oleh Admin Kalbe Medical pada May 10, 2017 07:30

Efektivitas Dexamethasone dibandingkan dengan Corticosteroid lain untuk Pengobatan Eksaserbasi Asma

Asma adalah penyakit peradangan kronik pada saluran napas bawah yang ditandai dengan gejala batuk, sesak napas, dada tertekan, dan wheezing. Penyakit ini dapat mengenai dewasa ataupun anak-anak. Pada penyakit asma, dapat terjadi episode perburukan gejala yang dikenal dengan istilah eksaserbasi. Pada eksaserbasi, terjadi perburukan gejala batuk, sesak napas, dada tertekan, dan wheezing. Menurut panduan GINA, pertolongan pertama pada eksaserbasi dapat menggunakan short acting beta2 agonist, misalnya salbutamol, dalam bentuk metered dose inhaler (MDI). Akan tetapi, apabila telah menggunakan salbutamol MDI beberapa kali ternyata masih belum membaik, maka disarankan untuk segera berobat ke rumah sakit.

Pengobatan eksaserbasi asma, membutuhkan kombinasi dari beberapa obat, antara lain short acting beta2 agonist (misalnya: salbutamol inhalasi), corticosteroid sistemik (misalnya: dexamethasone), dan support oksigen. Sampai saat ini masih belum disepakati mengenai obat corticosteroid apa yang paling baik di antara beberapa pilihan corticosteroid, misalnya: methylprednisolone, prednisolone, dan dexamethasone.1


Oleh karena itu, dr. Gonzalo dan tim melakukan sebuah metaanalisis untuk mengetahui di antara beberapa pilihan corticosteroid mana yang paling efektif dan aman untuk digunakan sebagai pengobatan pada pasien eksaserbasi asma pada anak-anak. Metaanalisis ini mengambil data dari 10 uji klinik. Corticosteroid yang dievaluasi pada 10 uji klinik ini antara lain: prednisolone, methylprednisolone, prednisone, dan dexamethasone.


Setelah dievaluasi, didapatkan hasil bahwa di antara kelompok dexamethasone dibandingkan dengan corticosteroid lain, tidak didapatkan perbedaan bermakna pada kejadian rawat inap antara kedua kelompok dan tidak didapatkan perbedaan bermakna pada kejadian relaps antara kedua kelompok. Selain itu, pada kelompok dexamethasone dibandingkan dengan corticosteroid lain, didapatkan kecenderungan bahwa efek samping pada kelompok dexamethasone lebih sedikit dibandingkan dengan corticosteroid lain.


Kesimpulan:
Pada pasien anak-anak yang mengalami eksaserbasi asma, penggunaan dexamethasone sebagai corticosteroid, efektivitasnya sebanding dengan corticosteroid lainnya. (NNO)

Image : Ilustrasi
Referensi:
1.Pediatric asthma: Practice essentials, background, pathophysiology [Internet]. 2017 Apr 12 [cited 2017 Apr 26]. Available from: http://emedicine.medscape.com/article/1000997-overview
2.Bravo-Soto GA, Harismendy C, Rojas P, Silva R, von Borries P. Is dexamethasone as effective as other corticosteroids for acute asthma exacerbation in children? Medwave [Internet]. 2017 Apr 20 [cited 2017 Apr 26];17(Suppl2). Available from: /link.cgi/English/Updates/Epistemonikos/6932.act

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