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每日一次支气管扩张剂茚达特罗在慢性阻塞性肺疾病中的作用。

Role of indacaterol, a once-daily bronchodilator, in chronic obstructive pulmonary disease.

作者信息

Seth Heemesh D, Sultan Samir, Gotfried Mark H

机构信息

Banner Good Samaritan Medical Center, Phoenix, AZ, USA.

Pulmonary Associates PA, Phoenix, AZ, USA ; University of Arizona, Phoenix, AZ, USA.

出版信息

J Thorac Dis. 2013 Dec;5(6):806-14. doi: 10.3978/j.issn.2072-1439.2013.10.11.

Abstract

Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction that can lead to lung destruction and dyspnea. Although there has been a slight reduction in mortality in recent decades, COPD is still a serious health problem that has enormous costs and utilizes significant medical resources. There have been a number of pharmacologic interventions that have been developed for the treatment of COPD. Current guidelines recommend the use of long-acting bronchodilators for the treatment of moderate and severe stage COPD, since they have been shown to improve lung function, respiratory symptoms, and quality of life. Indacaterol is a once-daily beta2-agonist (β2-agonist) delivered by a single-dose dry powder inhaler used for the treatment of COPD. It is currently approved at a dose of 75 μg in the United States and a dose of 150 μg with a maximal dose of 300 μg in Europe and other countries. Several studies show that indacaterol was statistically superior to both long-acting β2-agonist, formoterol and salmeterol, as well as, noninferior to tiotropium. Indacaterol is generally well tolerated and has a good safety profile. Other studies show that there is an additive bronchodilator response with the addition of indacaterol to tiotropium, which would provide a once-daily treatment option for patient with moderate to severe COPD. This review discusses the pharmacokinetic, comparative efficacy and safety data for indacaterol.

摘要

慢性阻塞性肺疾病(COPD)的特征是进行性气流受限,可导致肺组织破坏和呼吸困难。尽管近几十年来死亡率略有下降,但COPD仍然是一个严重的健康问题,造成巨大的经济成本并消耗大量医疗资源。目前已开发出多种用于治疗COPD的药物干预措施。现行指南推荐使用长效支气管扩张剂治疗中度和重度COPD,因为它们已被证明可改善肺功能、缓解呼吸道症状并提高生活质量。茚达特罗是一种每日一次的β2受体激动剂,通过单剂量干粉吸入器给药,用于治疗COPD。目前在美国其批准剂量为75μg,在欧洲及其他国家批准剂量为150μg,最大剂量为300μg。多项研究表明,茚达特罗在统计学上优于长效β2受体激动剂福莫特罗和沙美特罗,并且不劣于噻托溴铵。茚达特罗一般耐受性良好,安全性也较好。其他研究表明,在噻托溴铵基础上加用茚达特罗可产生相加的支气管扩张作用,这将为中重度COPD患者提供一种每日一次的治疗选择。本综述讨论了茚达特罗的药代动力学、疗效对比及安全性数据。

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