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每日一次的格隆溴铵(思力华能倍乐(®))用于治疗慢性阻塞性肺疾病(COPD)。

Once-daily glycopyrronium bromide (Seebri Breezhaler(®)) for the treatment of chronic obstructive pulmonary disease (COPD).

作者信息

Ulrik Charlotte Suppli

机构信息

a Department of Pulmonary Medicine , Hvidovre Hospital , DK-2650 Hvidovre , Denmark.

b Institute of Clinical Medicine , University of Copenhagen , Copenhagen , Denmark.

出版信息

Expert Opin Pharmacother. 2015;16(17):2653-9. doi: 10.1517/14656566.2015.1100171. Epub 2015 Dec 5.

Abstract

INTRODUCTION

Long-acting bronchodilators are the mainstay of pharmacological therapy for patients with chronic obstructive pulmonary disease (COPD). The choice of optimal bronchodilator therapy for COPD is increasingly difficult for clinicians as new treatments are marketed.

AREAS COVERED

Inhaled glycopyrronium bromide (Seebri Breezhaler®) is a well-tolerated long-acting anti-muscarinic agent (LAMA) with a fast onset of action. In patients with moderate to severe COPD, glycopyrronium bromide has clinically important effects on level of FEV1, use of relief medication, day-time dyspnea scores, and probably also on health status. Furthermore, glycopyrronium bromide also has beneficial effects on dynamic hyperinflation and, probably by that, exercise tolerance. Glycopyrronium bromide has been shown to reduce the rate of exacerbations in patients with moderate to severe COPD, although as a secondary outcome only.

EXPERT OPINION

Once-daily inhaled glycopyrronium bromide has positive impact on important COPD outcomes, comparable to the effects of other marketed LAMAs. Once-daily administration may improve adherence, and glycopyrronium bromide has the potential for a role in the future management of COPD similar to that of other long-acting anti-muscarinic agents, including tiotropium. Studies of glycopyrronium bromide with exacerbation rate as the primary outcome of interest is needed.

摘要

引言

长效支气管扩张剂是慢性阻塞性肺疾病(COPD)患者药物治疗的主要手段。随着新治疗方法上市,临床医生为COPD患者选择最佳支气管扩张剂治疗变得越来越困难。

涵盖领域

吸入用格隆溴铵(思力华能倍乐®)是一种耐受性良好的长效抗胆碱能药物(LAMA),起效迅速。在中度至重度COPD患者中,格隆溴铵对第一秒用力呼气容积(FEV1)水平、缓解药物使用、日间呼吸困难评分以及可能对健康状况都有重要临床作用。此外,格隆溴铵对动态肺过度充气也有有益作用,可能因此对运动耐量也有作用。已表明格隆溴铵可降低中度至重度COPD患者的急性加重率,不过这只是次要结果。

专家观点

每日一次吸入格隆溴铵对重要的COPD结局有积极影响,与其他已上市的长效抗胆碱能药物效果相当。每日一次给药可能会提高依从性,格隆溴铵在未来COPD管理中的作用潜力与包括噻托溴铵在内的其他长效抗胆碱能药物类似。需要开展以急性加重率作为主要研究终点的格隆溴铵研究。

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