D'Urzo Tony, Donohue James F, Price David, Miravitlles Marc, Kerwin Edward
a 1 Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
b 2 University of North Carolina, Chapel Hill, NC, USA.
Expert Rev Respir Med. 2015 Oct;9(5):519-32. doi: 10.1586/17476348.2015.1081065. Epub 2015 Aug 26.
Inhaled bronchodilator therapy is a mainstay of treatment for chronic obstructive pulmonary disease (COPD). Despite the number and types of treatments available, the control of symptoms and exacerbations remains suboptimal, and adherence to, and persistence with, inhaled therapy is generally poor. Results from clinical studies suggest that dual bronchodilator therapy with long-acting muscarinic receptor antagonists (LAMAs) and long-acting β2 adrenergic receptor agonists (LABAs) may provide additional benefit over LAMA or LABA monotherapy without additive effects on safety and tolerability. Several combinations of a LAMA plus a LABA have recently become available in a single inhaler for maintenance therapy for adults with moderate-to-severe COPD, including aclidinium bromide/formoterol fumarate, glycopyrronium/indacaterol and umeclidinium/vilanterol. Here, we review clinical data demonstrating significant improvements in bronchodilation, 24-h symptoms, and health status with aclidinium/formoterol twice daily, and discuss how this treatment can be implemented in clinical practice as part of a patient-focused approach to disease control.
吸入性支气管扩张剂治疗是慢性阻塞性肺疾病（COPD）治疗的主要手段。尽管现有治疗方法的数量和种类众多，但症状控制和急性加重的预防仍不尽人意，而且吸入治疗的依从性和持续性普遍较差。临床研究结果表明，长效毒蕈碱受体拮抗剂（LAMA）与长效β2肾上腺素能受体激动剂（LABA）联合使用的双重支气管扩张剂治疗，相较于LAMA或LABA单药治疗，可能会带来额外益处，且对安全性和耐受性无叠加影响。近期，几种LAMA加LABA的组合已制成单一吸入器，用于中重度COPD成人患者的维持治疗，包括阿地溴铵/富马酸福莫特罗、格隆溴铵/茚达特罗和乌美溴铵/维兰特罗。在此，我们回顾了临床数据，这些数据表明，每日两次使用阿地溴铵/福莫特罗可显著改善支气管扩张、24小时症状及健康状况，并讨论了如何将这种治疗方法作为以患者为中心的疾病控制方法的一部分应用于临床实践。
