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茚达特罗/格隆溴铵/糠酸莫米松固定剂量复方制剂用于未控制的哮喘。

Indacaterol/glycopyrronium/mometasone fixed dose combination for uncontrolled asthma.

机构信息

Department of Health Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy.

Respiratory Disease Unit, University Hospital of Catania, Catania, Italy.

出版信息

Expert Rev Respir Med. 2022 Feb;16(2):183-195. doi: 10.1080/17476348.2021.2011222. Epub 2021 Dec 23.

Abstract

INTRODUCTION

Asthma symptoms can be relieved through a maintenance treatment combining long-acting β-agonist and inhaled corticosteroids (LABA/ICS). However, for patients with inadequately controlled asthma, the LABA/ICS combination might not be sufficient, and clinical guidelines recommend the administration of inhaled long-acting muscarinic antagonists (LAMA) as an add-on therapy to better control asthma and improve lung function. For nearly two decades, the only LAMA to be approved on the market has been tiotropium.

AREAS COVERED

We reviewed recent clinical studies evaluating the safety and efficacy of LABA/LAMA/ICS fixed dose combinations by searching the PubMed database. Molecular mechanisms and clinical data support the use of a once-daily, single-inhaler fixed dose combination of the LABA/LAMA/ICS indacaterol/glycopyrronium/mometasone (IND/GLY/MF), the first therapy combining three agents in a fixed dose approved in Europe for the treatment of uncontrolled asthma.

EXPERT OPINION

IND/GLY/MF was superior to both IND/MF and salmeterol/fluticasone, a well-established LABA/ICS combination improving the lung function in uncontrolled asthma. Moreover, IND/GLY/MF, delivered through the Breezhaler inhaler in a single inhalation, is the first inhaled therapy prescribed alongside a digital companion, a sensor and the Propeller app, allowing for improved treatment adherence, reduced rescue inhaler usage and hospitalizations, increased patient satisfaction and asthma control.

摘要

简介

通过长效β-激动剂和吸入皮质类固醇(LABA/ICS)的维持治疗可以缓解哮喘症状。然而,对于哮喘控制不佳的患者,LABA/ICS 联合治疗可能不够,临床指南建议使用吸入长效抗胆碱能药物(LAMA)作为附加治疗,以更好地控制哮喘并改善肺功能。近二十年来,市场上唯一批准的 LAMA 是噻托溴铵。

涵盖领域

我们通过搜索 PubMed 数据库,回顾了最近评估 LABA/LAMA/ICS 固定剂量联合治疗安全性和疗效的临床研究。分子机制和临床数据支持使用每日一次、单吸入器的 LABA/LAMA/ICS 茚达特罗/格隆溴铵/糠酸莫米松(IND/GLY/MF)固定剂量联合治疗,这是欧洲批准的第一种用于治疗未控制哮喘的三联固定剂量联合治疗药物。

专家意见

IND/GLY/MF 优于 IND/MF 和沙美特罗/氟替卡松,后者是一种成熟的 LABA/ICS 联合治疗药物,可以改善未控制哮喘的肺功能。此外,通过 Breezhaler 吸入器单次吸入给药的 IND/GLY/MF 是第一种与数字伴侣、传感器和 Propeller 应用程序一起开处方的吸入治疗药物,从而提高了治疗依从性,减少了急救吸入器的使用和住院治疗,提高了患者满意度和哮喘控制水平。

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