tailieunhanh - Báo cáo y học: " Long-acting beta-agonists in the management of chronic obstructive pulmonary disease: current and future agents"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học 'Respiratory Research cung cấp cho các bạn kiến thức về ngành y đề tài: Long-acting beta-agonists in the management of chronic obstructive pulmonary disease: current and future agents. | Tashkin and Fabbri Respiratory Research 2010 11 149 http content 11 1 149 RESPIRATORY RESEARCH REVIEW Open Access Long-acting beta-agonists in the management of chronic obstructive pulmonary disease current and future agents Donald P Tashkin1 Leonardo M Fabbri2 Abstract Chronic obstructive pulmonary disease COPD is characterized by progressive airflow limitation and debilitating symptoms. For patients with moderate-to-severe COPD long-acting bronchodilators are the mainstay of therapy as symptoms progress guidelines recommend combining bronchodilators from different classes to improve efficacy. Inhaled long-acting p2-agonists LABAs have been licensed for the treatment of COPD since the late 1990s and include formoterol and salmeterol. They improve lung function symptoms of breathlessness and exercise limitation health-related quality of life and may reduce the rate of exacerbations although not all patients achieve clinically meaningful improvements in symptoms or health related quality of life. In addition LABAs have an acceptable safety profile and are not associated with an increased risk of respiratory mortality although adverse effects such as palpitations and tremor may limit the dose that can be tolerated. Formoterol and salmeterol have 12-hour durations of action however sustained bronchodilation is desirable in COPD. A LABA with a 24-hour duration of action could provide improvements in efficacy compared with twice-daily LABAs and the once-daily dosing regimen could help improve compliance. It is also desirable that a new LABA should demonstrate fast onset of action and a safety profile at least comparable to existing LABAs. A number of novel LABAs with once-daily profiles are in development which may be judged against these criteria. Indacaterol a LABA with a 24-hour duration of bronchodilation and fast onset of action is the most advanced of these. Preliminary results from large clinical trials suggest indacaterol improves lung .