使用吸入长效支气管扩张剂治疗慢性阻塞性肺疾病的不良心血管事件风险。
Risk of adverse cardiovascular events with use of inhaled long-acting bronchodilators in management of chronic obstructive pulmonary disease.
机构信息
School of Pharmacy, National Defense Medical Center, Taipei, Taiwan.
Division of Pulmonary and Critical Care, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
出版信息
J Food Drug Anal. 2019 Jul;27(3):657-670. doi: 10.1016/j.jfda.2018.12.006. Epub 2019 Jan 7.
Abstract
Inhaled long-acting bronchodilators, including long-acting β agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) are the mainstay therapy in the treatment of chronic obstructive pulmonary disease (COPD), a disease that poses a heavy burden on morbidity and mortality worldwide. Use of LABAs and LAMAs in patients with COPD, however, has been concerned about an increased risk of adverse cardiovascular events, despite inconsistent findings reported from randomized controlled trials (RCTs) and observational studies. In this review, we detailed the relevant evidence generated from RCTs and observational studies with respect to the risk of cardiovascular disease with use of LABAs and LAMAs in management of COPD, and analyzed the contradictory findings in the literature, as well as recommended future research directions to clear the air regarding the cardiovascular safety of inhaled long-acting bronchodilators.
摘要
吸入长效支气管扩张剂，包括长效β受体激动剂（LABAs）和长效抗胆碱能药物（LAMAs），是治疗慢性阻塞性肺疾病（COPD）的主要方法，该病在全球造成了沉重的发病率和死亡率负担。然而，尽管随机对照试验（RCTs）和观察性研究报告的结果不一致，LABAs 和 LAMAs 在 COPD 患者中的使用一直存在心血管不良事件风险增加的担忧。在这篇综述中，我们详细介绍了 RCTs 和观察性研究中关于使用 LABA 和 LAMA 治疗 COPD 时心血管疾病风险的相关证据，并分析了文献中的矛盾发现，以及推荐了未来的研究方向，以澄清吸入长效支气管扩张剂的心血管安全性问题。
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