Ulrik C S, Kok-Jensen A
Dept of Pulmonary Medicine, Bispebjerg Hospital, Copenhagen, Denmark.
Eur Respir J. 1994 May;7(5):1003-5.
New long-acting beta 2-adrenoceptor agonists, salmeterol and formoterol, have recently been marketed for treatment of asthma, but studies comparing the clinical efficacy of the two drugs have not been published. We report on an asthmatic patient who had a striking difference in bronchodilating effect of the two drugs, formoterol being more effective than salmeterol both in immediate response and during long-term treatment. Although, both formoterol and salmeterol are highly selective for the beta 2-adrenoceptors (comparable to salbutamol and terbutaline), differences in their chemical structure suggest differences in their mechanisms of action or receptor specificity. The clinical implication of our observation appears to be that a less favourable response in an individual patient to one of the long-acting beta 2-agonists should not preclude a trial with another. Future studies comparing the clinical efficacy of formoterol and salmeterol should probably also address the question of responders and nonresponders to these drugs; and furthermore, seek to explore a possible relationship to inherited variance in beta 2-receptors.
新型长效β2肾上腺素能受体激动剂沙美特罗和福莫特罗最近已上市用于治疗哮喘，但比较这两种药物临床疗效的研究尚未发表。我们报告了一名哮喘患者，这两种药物的支气管扩张效果存在显著差异，福莫特罗在即时反应和长期治疗中均比沙美特罗更有效。虽然福莫特罗和沙美特罗对β2肾上腺素能受体均具有高度选择性（与沙丁胺醇和特布他林相当），但其化学结构的差异表明它们在作用机制或受体特异性方面存在差异。我们观察结果的临床意义似乎是，个体患者对其中一种长效β2激动剂反应不佳不应排除试用另一种药物。未来比较福莫特罗和沙美特罗临床疗效的研究可能还应解决对这些药物有反应者和无反应者的问题；此外，还要探索与β2受体遗传变异的可能关系。
