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β-肾上腺素能受体拮抗剂治疗慢性阻塞性肺疾病的疗效和安全性概述。

An overview of the efficacy and safety of β-adrenoceptor antagonists for the treatment of chronic obstructive pulmonary disease.

机构信息

Unit of Pharmacology, Department of Experimental Medicine, School of Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.

Unit of Respiratory Medicine, Department Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.

出版信息

Expert Opin Drug Saf. 2024 Jul;23(7):833-844. doi: 10.1080/14740338.2024.2362817. Epub 2024 Jun 2.

Abstract

INTRODUCTION

The safety of β-AR antagonists in the treatment of patients with COPD continues to be a topic of research and discussion within the medical community. Emerging evidence suggests potentially benefits in the management of this complex respiratory condition. However, antagonists that display a preference for β-AR over β-AR present a complex therapeutic challenge in COPD management, necessitating an understanding of differences in their pharmacological profiles and clinical implications.

AREAS COVERED

An overview of the mechanisms of action of β-AR antagonists and their potential impact on respiratory function, their pharmacological interactions, clinical implications, and future perspectives in COPD.

EXPERT OPINION

β-Blockers have the potential to become a versatile class of therapeutic agents with benefits beyond their original cardiovascular use. However, the one-size-fits-all approach of prescribing β-blockers regardless of their receptor selectivity to COPD patients with concomitant heart disease may not be appropriate. Instead, it is advisable to develop an individualized treatment strategy based on a thorough assessment of the patient's overall health. The use of non selective β-AR antagonists, functioning as inverse agonists at β-ARs, has garnered interest and debate, but further research efforts should focus on elucidating the optimal use of β-AR antagonists in COPD, balancing cardiovascular benefits with potential respiratory risks to enhance outcomes and quality of life for individuals living with this debilitating respiratory condition.

摘要

简介

β-AR 拮抗剂在 COPD 患者治疗中的安全性仍然是医学界研究和讨论的一个话题。新出现的证据表明,β-AR 拮抗剂在管理这种复杂的呼吸系统疾病方面可能具有潜在的益处。然而,与β-AR 相比,β-AR 具有选择性的拮抗剂在 COPD 管理中带来了复杂的治疗挑战,这需要了解它们在药理学特征和临床意义方面的差异。

涵盖的领域

β-AR 拮抗剂的作用机制概述及其对呼吸功能的潜在影响、它们的药理学相互作用、临床意义以及在 COPD 中的未来展望。

专家意见

β-受体阻滞剂有可能成为一类具有超越原有心血管用途的多功能治疗药物。然而,对于同时患有心脏病的 COPD 患者,不分其受体选择性而一概开处方β-受体阻滞剂的一刀切方法可能并不合适。相反,建议根据患者的整体健康状况进行全面评估,制定个体化的治疗策略。非选择性β-AR 拮抗剂作为β-AR 的反向激动剂引起了关注和争议,但进一步的研究应集中阐明β-AR 拮抗剂在 COPD 中的最佳使用,平衡心血管益处与潜在的呼吸风险,以提高患有这种使人衰弱的呼吸系统疾病的个体的预后和生活质量。

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