Crisafulli Ernesto, Frizzelli Annalisa, Fantin Alberto, Manco Alessandra, Mangia Angelo, Pisi Giovanna, Fainardi Valentina, Alfieri Veronica, Aiello Marina, Bertorelli Giuseppina, Chetta Alfredo
a Respiratory Disease and Lung Function Unit, Department of Medicine and Surgery , University of Parma , Parma , Italy.
b Cystic Fibrotic Centre , University Hospital , Parma , Italy.
Expert Opin Pharmacother. 2017 Oct;18(14):1499-1505. doi: 10.1080/14656566.2017.1378348. Epub 2017 Sep 14.
A fixed-dose inhalation of a long-acting β-agonist (LABA) and inhaled corticosteroids (ICS) is commonly recommended for moderate to severe asthmatic patients not adequately controlled by an ICS only. In order to improve the patients' adherence and the control of disease there is a noteworthy interest for the next generation inhaled β adrenoreceptor agonists maintaining an over 24 hours bronchodilatation and used once-daily (ultra-LABAs). This review focuses on the currently available evidences on the clinical role of any single ultra-LABAs in the treatment of asthmatic patients. Areas covered: New ultra-LABAs have been developed in recent years for the treatment of asthma. In particular, several evidences in asthmatic patients include indacaterol, vilanterol, olodaterol, and abediterol. Expert opinion: Pharmacologically, all new ultra-LABAs considered have demonstrated a good ability to maintain a true bronchodilatation for over 24 hours and a good safety profile. This aspect could be a key point to improve the patient's perspective, the adherence to the treatment regimens and therefore the control of disease. At this time, however, limited data are available and no ultra-LABA+ICS may be recommended as preferred.
对于仅使用吸入性糖皮质激素（ICS）无法得到充分控制的中重度哮喘患者，通常建议固定剂量吸入长效β受体激动剂（LABA）和ICS。为了提高患者的依从性以及疾病控制效果，下一代能维持超过24小时支气管扩张且每日使用一次的吸入性β肾上腺素能受体激动剂（超长效LABA）受到了显著关注。本综述聚焦于目前关于任何一种单一超长效LABA在哮喘患者治疗中临床作用的现有证据。涵盖领域：近年来已研发出用于治疗哮喘的新型超长效LABA。特别是，在哮喘患者中有多项证据涉及茚达特罗、维兰特罗、奥洛他定和阿地特罗。专家观点：从药理学角度来看，所有被考虑的新型超长效LABA均已证明具有良好的维持超过24小时真正支气管扩张的能力以及良好的安全性。这一方面可能是改善患者状况、提高治疗方案依从性进而控制疾病的关键要点。然而，目前可用数据有限，尚无超长效LABA加ICS可被推荐为首选。
