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The short, the long and the "ultra-long": why duration of bronchodilator action matters in chronic obstructive pulmonary disease.
Adv Ther. 2010 Mar; 27(3):150-9.AT

Abstract

Bronchodilators are the cornerstone of symptomatic treatment for all chronic obstructive pulmonary disease (COPD) severity stages when administered on a regular basis to prevent or reduce symptoms and exacerbations. The principal inhaled bronchodilator treatments are beta-2 agonists and anticholinergics, used singularly or in combination. There is good evidence that regular treatment with long-acting bronchodilators is more effective and convenient than treatment with short-acting bronchodilators. Long-acting agents include the twice-daily beta-2 agonists formoterol and salmeterol, the once-daily anticholinergic tiotropium, and, more recently, the once-daily beta-2 agonist indacaterol. Long-acting bronchodilators have been shown to improve multiple clinical outcomes in COPD in comparison to short-acting agents including lung function, symptoms, dyspnea, quality of life, and exacerbations. Studies of head-to-head comparisons of long-acting bronchodilators are scant but indicate superior bronchodilation of tiotropium over salmeterol, while preliminary data from trials with the novel once-daily beta-2 agonist indacaterol indicate superior bronchodilation and clinical efficacy over twice-daily long-acting beta-2 agonists and at least equipotent bronchodilation as once-daily tiotropium. These recent therapeutic developments in COPD represent a change of paradigm with a shift from short-acting bronchodilators with multiple dosing per day to reduced dosing frequency and prolonged duration of action including once-daily treatment. This review summarizes relevant data and landmark studies comparing the efficacy of short-acting versus longer-acting bronchodilators in COPD, including new data for once-daily indacaterol, and discusses potential mechanism underlying the improved efficacy of long-acting versus short-acting bronchodilators.

Authors+Show Affiliations

Insaf Respiratory Research Institute, Wiesbaden, Germany. k.beeh@insaf-wi.deNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

20411368

Citation

Beeh, Kai M., and Jutta Beier. "The Short, the Long and the "ultra-long": Why Duration of Bronchodilator Action Matters in Chronic Obstructive Pulmonary Disease." Advances in Therapy, vol. 27, no. 3, 2010, pp. 150-9.
Beeh KM, Beier J. The short, the long and the "ultra-long": why duration of bronchodilator action matters in chronic obstructive pulmonary disease. Adv Ther. 2010;27(3):150-9.
Beeh, K. M., & Beier, J. (2010). The short, the long and the "ultra-long": why duration of bronchodilator action matters in chronic obstructive pulmonary disease. Advances in Therapy, 27(3), 150-9. https://doi.org/10.1007/s12325-010-0017-6
Beeh KM, Beier J. The Short, the Long and the "ultra-long": Why Duration of Bronchodilator Action Matters in Chronic Obstructive Pulmonary Disease. Adv Ther. 2010;27(3):150-9. PubMed PMID: 20411368.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The short, the long and the "ultra-long": why duration of bronchodilator action matters in chronic obstructive pulmonary disease. AU - Beeh,Kai M, AU - Beier,Jutta, Y1 - 2010/04/19/ PY - 2010/03/08/received PY - 2010/4/23/entrez PY - 2010/4/23/pubmed PY - 2010/8/18/medline SP - 150 EP - 9 JF - Advances in therapy JO - Adv Ther VL - 27 IS - 3 N2 - Bronchodilators are the cornerstone of symptomatic treatment for all chronic obstructive pulmonary disease (COPD) severity stages when administered on a regular basis to prevent or reduce symptoms and exacerbations. The principal inhaled bronchodilator treatments are beta-2 agonists and anticholinergics, used singularly or in combination. There is good evidence that regular treatment with long-acting bronchodilators is more effective and convenient than treatment with short-acting bronchodilators. Long-acting agents include the twice-daily beta-2 agonists formoterol and salmeterol, the once-daily anticholinergic tiotropium, and, more recently, the once-daily beta-2 agonist indacaterol. Long-acting bronchodilators have been shown to improve multiple clinical outcomes in COPD in comparison to short-acting agents including lung function, symptoms, dyspnea, quality of life, and exacerbations. Studies of head-to-head comparisons of long-acting bronchodilators are scant but indicate superior bronchodilation of tiotropium over salmeterol, while preliminary data from trials with the novel once-daily beta-2 agonist indacaterol indicate superior bronchodilation and clinical efficacy over twice-daily long-acting beta-2 agonists and at least equipotent bronchodilation as once-daily tiotropium. These recent therapeutic developments in COPD represent a change of paradigm with a shift from short-acting bronchodilators with multiple dosing per day to reduced dosing frequency and prolonged duration of action including once-daily treatment. This review summarizes relevant data and landmark studies comparing the efficacy of short-acting versus longer-acting bronchodilators in COPD, including new data for once-daily indacaterol, and discusses potential mechanism underlying the improved efficacy of long-acting versus short-acting bronchodilators. SN - 1865-8652 UR - https://www.unboundmedicine.com/medline/citation/20411368/The_short_the_long_and_the_"ultra_long":_why_duration_of_bronchodilator_action_matters_in_chronic_obstructive_pulmonary_disease_ L2 - https://dx.doi.org/10.1007/s12325-010-0017-6 DB - PRIME DP - Unbound Medicine ER -