Naslov
Inhaled pharmacologic therapy for treatment of stable chronic obstructive pulmonary disease

Autori
Pavliša, Gordana ; Hodak, Petra ; Hohšteter, Bea ; Lampalo, Marina ; Vukić Dugac, Andrea ; Samaržija, Miroslav

Izvornik
Medicus (1330-013X) 27 (2018), 2; 197-203

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, stručni

Ključne riječi
Chronic obstructive pulmonary disease ; Inhaled corticosteroids ; Long-acting beta-2 agonists ; Long-acting muscarinic antagonists

Sažetak
Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow obstruction caused by chronic inflammatory response of the airways and the lung parenchyma to noxious particles or gases. The main goals of pharmacologic therapy are to reduce symptoms and the frequency and severity of exacerbations, as well as to improve exercise tolerance and health status. The mainstays of drug therapy of stable symptomatic COPD are inhaled bronchodilators (beta-agonists and anticholinergics) alone or in combination with inhaled corticosteroids (ICS). Regular use of long-acting bronchodilators is recommended for the management of patients with persistent symptoms. Compared to placebo, long- acting bronchodilators significantly improve lung function and health-related quality of life while reducing exacerbation rates. Overall, long-acting muscarinic antagonists (LAMAs) lead to greater improvement in lung function parameters, reduction in acute exacerbation rates and fewer adverse effects compared with long-acting beta-2 agonists (LABAs). In patients whose disease is not sufficiently controlled with monotherapy, guidelines recommend combination therapy involving two long-acting bronchodilators with differing modes of action. Compared with monotherapy, LAMA/LABA combination therapy significantly improves lung function, symptoms and health status. The safety profile of the LAMA/LABA combination therapy is similar to the safety profiles of LABAs and LAMAs when administered as monotherapy. In patients prone to exacerbations, an ICS combined with LABA is more effective than either component alone in improving lung function, health status and reducing exacerbations. In patients with severe to very severe COPD and increased exacerbation risk, triple therapy consisting of ICS, LABAs and LAMAs additionally improves lung function, reduces exacerbation rates and dyspnea compared to ICS/LABA combination therapy.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti

POVEZANOST RADA