scholarly journals Bronchial reversibility with a short-acting β2-agonist predicts the FEV1 response to administration of a long-acting β2-agonist with inhaled corticosteroids in patients with bronchial asthma

2011 ◽  
Vol 2 (4) ◽  
pp. 619-623 ◽  
Author(s):  
AKIHIKO OHWADA ◽  
KEI INAMI ◽  
EMI ONUMA ◽  
MARIKO MATSUMOTO-YAMAZAKI ◽  
RYO ATSUTA ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Short Acting ◽  
Long Acting ◽  
Β2 Agonist

Patterns of use and trends in the use of medications for the control of COPD in a cohort of Colombian patients, 2017-2019 v1

2021 ◽  
Author(s):  
Jorge Machado Alba
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Chronic Obstructive ◽  
Population Database ◽  
Obstructive Pulmonary Disease ◽  
Prescription Patterns ◽  
Short Acting ◽  
Patterns Of Use ◽  
Long Acting

Introduction: Chronic obstructive pulmonary disease (COPD) affects approximately 174 million people worldwide.The objective was to determine the trends of the use of medications for COPD in a group of Colombian patients. Methods: This was a retrospective study on prescription patterns of bronchodilators and other medications used in COPD from a population database with follow-up at 12 and 24 months. Patients older than 18 years of age of any sex who had COPD between 2017 and 2019 were included. Sociodemographic variables, medications, treatment schedules for COPD, comorbidities, comedications, and the specialty of the prescriber were considered. Results: A total of 9,476 people with a diagnosis of COPD were evaluated. They had a mean age of 75.9 ± 10.7 years, 50.1% were men, and 86.8% were prescribed by a general practitioner. At the beginning of the follow-up, on average, they received 1.6 medications/patient, mainly short-acting antimuscarinics (3784; 39.9%), followed by short-acting β-agonists (2997, 31.6%) and inhaled corticosteroids (ICS) (2239, 23.6%), but 5083 (53.6%) patients received a long-acting bronchodilator. At the beginning of the follow-up, 645 (6.8%) patients were put on triple therapy with antimuscarinics, β-agonists, and ICS, and at 12 months, this rose to 1388 (20.6%). A total of 57.9% had comorbidities, most often hypertension (44.4%). Conclusions: This group of patients with COPD treated in Colombia frequently received short-acting bronchodilators and ICS, but a growing proportion are undergoing controlled therapy with long-acting bronchodilators, a situation that can improve the indicators of morbidity, exacerbations, and hospitalization.

scholarly journals Cessation of long-acting β2-agonist in children with persistent asthma on inhaled corticosteroids

2016 ◽  
Vol 48 (2) ◽  
pp. 558-560 ◽  
Author(s):  
Francine M. Ducharme ◽  
Roxanne Gagnon ◽  
Brigitte Bénard ◽  
Sze Man Tse ◽  
Robert Thivierge
Keyword(s):  
Inhaled Corticosteroids ◽  
Persistent Asthma ◽  
Long Acting ◽  
Β2 Agonist

scholarly journals Pharmacotherapy of Chronic Obstructive Pulmonary Disease: A Clinical Review

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Balazs Antus
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Phosphodiesterase Inhibitor ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Mortality And Morbidity ◽  
Short Acting ◽  
Significant Burden ◽  
Long Acting

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality and morbidity worldwide. In addition to generating high healthcare costs, COPD imposes a significant burden in terms of disability and impaired quality of life. Unlike many leading causes of death and disability, COPD is projected to increase in many regions of the world as the frequency of smoking is rising and the population is aging. The pharmacological treatment of COPD includes bronchodilators to relax smooth muscle, such as β2-agonists (salbutamol, terbutaline, and fenoterol, short-acting β2-agonists as well as salmeterol, formoterol, and indacaterol, and long-acting β2-agonists) and anticholinergics, such as ipratropium, oxitropium (short-acting anticholinergic), and tiotropium (long-acting anticholinergic). Although airway inflammation in COPD poorly responds to steroids, several inhaled corticosteroids (fluticasone, budesonide, and beclomethasone) are in use in combination with long-acting β2-agonists. Other medications include theophylline (both a bronchodilator and a phosphodiesterase inhibitor) and the phosphodiesterase-4 antagonists, such as roflumilast. Finally, a number of novel long-acting anticholinergics and β2-agonists with once- or twice-daily profiles are in development and clinical testing.

scholarly journals Rapid nongenomic actions of inhaled corticosteroids on long-acting β2-agonist transport in the airway

2011 ◽  
Vol 24 (6) ◽  
pp. 654-659 ◽  
Author(s):  
Gabor Horvath ◽  
Eliana S. Mendes ◽  
Nathalie Schmid ◽  
Andreas Schmid ◽  
Gregory E. Conner ◽  
...  
Keyword(s):  
Inhaled Corticosteroids ◽  
Long Acting ◽  
Β2 Agonist

β 2-Adrenoceptor polymorphism and bronchoprotective sensitivity with regular short- and long-acting β2-agonist therapy

1999 ◽  
Vol 96 (3) ◽  
pp. 253-259 ◽  
Author(s):  
B. J. LIPWORTH ◽  
I. P. HALL ◽  
I. AZIZ ◽  
K. S. TAN ◽  
A. WHEATLEY
Keyword(s):  
Inhaled Corticosteroids ◽  
Forced Expiratory Volume ◽  
Double Blind ◽  
Geometric Means ◽  
Once Daily ◽  
Regular Treatment ◽  
Parallel Group ◽  
Long Acting ◽  
To Receive ◽  
Β2 Agonist

The aim of the present study was to investigate bronchoprotective sensitivity in patients receiving regular treatment with short- and long-acting β2-agonists and to evaluate any possible association with genetic polymorphism. Thirty-eight patients with stable mild to moderate asthma and receiving inhaled corticosteroids were randomized in a parallel group, double-blind, double-dummy fashion to receive 2 weeks of treatment with either formoterol (12μg once daily, 6μg twice daily or 24μg twice daily) or terbutaline (500μg four times daily). Bronchoprotection against methacholine challenge (as a provocative dose to produce a 20% fall in forced expiratory volume in 1.0 ;s: PD20) was measured at baseline (unprotected) after an initial 1 week run-in without β2-agonist, and at 1 ;h after the first and last doses of each treatment. The PD20 values were log-transformed and calculated as change from baseline. Percentage desensitization of log PD20 for first- versus last-dose bronchoprotection was calculated and analysed according to effects of treatment and β2-adrenoceptor polymorphism at codon 16 or 27. The mean degree of desensitization for bronchoprotection was comparable with all four treatments and there were no significant differences in absolute PD20 values after 2 weeks of chronic dosing. The PD20 values were (as μg of methacholine, geometric means±S.E.M.): formoterol, 12μg once daily, 99±42μg; formoterol, 6μg twice daily, 107±44μg; formoterol, 24μg twice daily, 108±45μg; terbutaline, 500μg four times daily, 88±37μg. All patients receiving formoterol, 24μg twice daily, exhibited a loss of protection greater than 30% which was unrelated to polymorphism at codon 16 or 27. For codon 16, the use of lower doses of formoterol (12μg once daily or 6μg twice daily) showed wider variability in the propensity for protection loss in patients who were heterozygous, in contrast to a more uniform protection loss seen with homozygous glycine patients. The amount of protection loss was not significantly related to polymorphism at codon 16 or 27, expressed as values (mean±S.E.M.) for percentage desensitization according to each genotype (pooled treatments): Gly-16, 66±11%; Het-16, 53±8%; Arg-16, 69±18%; Glu-27, 68±12%; Het-27, 58±8%; Gln-27, 52±12%. The results of this preliminary study showed that bronchoprotective desensitization occurred readily in response to short- or long-acting β2-agonist exposure irrespective of β2-adrenoceptor polymorphism at codon 16 or 27. Further studies with larger patient numbers are required to further evaluate the effects of polymorphisms with lower doses of regular formoterol.

scholarly journals Tiotropium bromide: additional options for the treatment of bronchial asthma

2019 ◽  
Vol 16 (3) ◽  
pp. 67-74
Author(s):  
O M Kurbacheva ◽  
M E Dyneva
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Biological Properties ◽  
Additional Treatment ◽  
Tiotropium Bromide ◽  
Inhalation Therapy ◽  
Global Initiative For Asthma ◽  
Successful Control ◽  
Global Initiative ◽  
Long Acting

Bronchial asthma (BA) is one of the most common chronic diseases, characterized by airway inflammation and bronchospasm. Symptoms of BA are wheezing, shortness of breath, a feeling of constriction in the chest and cough, the frequency and severity of which vary greatly over time. Today studies of BA phenotypes allow selecting treatment depending on the particular pathogenesis of each phenotype individually, thereby helping to achieve control, which is the main goal of BA therapy. However, it is necessary to take into account the peculiarities of airway innervation, since an increased parasympathetic tone is characteristics of all BA phenotypes and plays an important role in the development of bronchoconstriction and inflammation. Therefore, tiotropium bromide, which is a long-acting blocker of muscarinic cholinergic receptors, is one of the main bronchodilators in the treatment of BA. It blocks bronchoconstriction, hypersecretion and swelling of the mucous membrane of the airway, which in turn prevents the progression of inflammation, and the prolonged action of tiotropium bromide, which allows it to be used once a day helps to achieve control of asthma in addition to basic inhalation therapy - inhaled corticosteroids (ICS) long-acting P2-agonists (LABA). According to GINA (Global Initiative for Asthma), tiotropium bromide is recommended as an additional treatment, starting from step 4, and in accordance with the Russian Federal Clinical Guidelines for Bronchial Asthma - from step 3. Currently, according to clinical studies, much is known about the mechanisms of action and biological properties of tiotropium bromide, which made it possible to substantiate the needs for its administration to patients with BA regardless of its phenotype. This strategy will contribute to a more successful control of BA considering risk factors and comorbidity, thereby reducing needs of increasing ICS dose.

scholarly journals The comparison of clinical efficacy of formoterol and fluticasone versus salmeterol and fluticasone in patients of bronchial asthma

2018 ◽  
Vol 7 (5) ◽  
pp. 947
Author(s):  
Akashdeep Rattu ◽  
Inderpal Kaur ◽  
Ashok Goel ◽  
Nirmal Chand Kajal
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Beta Agonist ◽  
Fixed Dose ◽  
Dose Inhaler ◽  
Open Label ◽  
Group A ◽  
Baseline Values ◽  
Long Acting ◽  
Group B

Background: Fixed-dose combinations of Inhaled corticosteroids (ICS) and Long acting beta agonist (LABA) are established and widely used treatment for bronchial asthma when ICSs as monotherapy are ineffective. This study attempted to compare the efficacy of salmeterol and fluticasone with formoterol (newer LABA) and fluticasone in patients of bronchial asthma.Methods: An open label, randomized, prospective, parallel and comparative study of eight-week duration was conducted on 80 patients of bronchial asthma, with the collaboration of Department of pharmacology and Department of Tuberculosis and Chest Diseases Hospital, Government medical college, Amritsar. Patients in Group A were treated with 2 actuations of Formoterol and Fluticasone (6/125µg) twice daily and group B patients were treated with 2 actuations of Salmeterol and Fluticasone (50/125µg) twice daily for 8 weeks with metered dose inhaler (MDI). Patients in group A and B were assessed on day zero, 4 weeks and 8 weeks for clinical assessment and computerized spirometry for FVC, FEV1, FEV1/FVC and PEFR.Results: In group A mean±SD of FEV1 statistically significantly increased (<0.001) after eight week of therapy (1.50±0.12) from its baseline values (1.34±0.11). Similarly, in group B mean ± SD of FEV1 statistically significantly increased (<0.001) after eight weeks (1.48±0.13) from its baseline values (1.36±0.12). There was statistically significant (<0.001) improvement in other parameters of spirometry in patients of both the groups.Conclusions: It was observed that both the combination of Fluticasone + Formoterol and Fluticasone + Salmeterol are effective in the treatment of bronchial asthma.

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