Muruganandan Sanjeevan, Jayaram Lata
Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, Victoria, Australia.
Department of Respiratory and Sleep Medicine, Western Health, Melbourne, Victoria, Australia ; University of Melbourne, Melbourne, Victoria, Australia.
Int J Chron Obstruct Pulmon Dis. 2015 Jun 18;10:1179-89. doi: 10.2147/COPD.S54154. eCollection 2015.
Chronic obstructive pulmonary disease (COPD) is a progressive, debilitating disorder that results in frequent exacerbations and impacts quality of life. It represents a growing burden of health care cost, both from societal and economic perspectives. Short- and long-acting bronchodilators remain the mainstay of therapy in COPD patients. New fixed-dose combination inhalers with novel pharmacological combinations of long-acting β2-agonists and muscarinic antagonists and delivered once-daily through a variety of devices are currently being developed and licensed for the treatment of COPD. There is mounting research suggesting that combining a fixed dose of a β2-agonist and a muscarinic antagonist achieves better bronchodilation and clinical outcomes compared with either agent alone. These once-daily dosing inhalers are anticipated to impact favorably on patient preference and compliance. This review examines the fixed-dose combination of tiotropium bromide and olodaterol delivered by a Respimat(®) Soft Mist™ inhaler at doses of 2.5/5 μg and 5/5 μg in moderate-to-very-severe COPD, and its potential role in COPD compared with other long-acting β2-agonist with long-acting muscarinic antagonist combinations and delivery devices.
慢性阻塞性肺疾病(COPD)是一种进行性、使人衰弱的疾病,会导致频繁发作并影响生活质量。从社会和经济角度来看,它给医疗保健成本带来了日益沉重的负担。短效和长效支气管扩张剂仍然是COPD患者治疗的主要手段。目前正在研发并已获批用于治疗COPD的新型固定剂量复方吸入器,其含有长效β2受体激动剂和毒蕈碱拮抗剂的新型药理组合,并通过多种装置每日给药一次。越来越多的研究表明,与单独使用任何一种药物相比,固定剂量的β2受体激动剂和毒蕈碱拮抗剂联合使用可实现更好的支气管扩张效果和临床疗效。这些每日一次给药的吸入器有望对患者的偏好和依从性产生积极影响。本综述探讨了在中重度至极重度COPD患者中,通过Respimat(®)Soft Mist™吸入器以2.5/5μg和5/5μg剂量递送的噻托溴铵与奥达特罗固定剂量复方制剂,以及与其他长效β2受体激动剂和长效毒蕈碱拮抗剂组合及给药装置相比,其在COPD中的潜在作用。