Long-acting beta2-agonists for stable chronic asthma

Walters, EH; Walters, Julia; Gibson, Mark

doi:10.1002/14651858.cd001385

Cited by 25 publications

(17 citation statements)

References 216 publications

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“…In asthmatics with persistent symptoms despite ICS use, treatment with combination therapy with ICSs and LABAs effectively controls chronic symptoms and reduces the frequency of exacerbations (Walters et al, 2003). It has recently been shown that early treatment of symptoms of worsening asthma with ICS/ LABA, where the LABA has a rapid onset of action and is used to relieve symptoms, does prevent deterioration leading to severe exacerbations (O'Byrne et al, 2005).…”

Section: Icss and Long Acting Beta Agonists (Labas)mentioning

confidence: 99%

Understanding the mechanisms of viral induced asthma: New therapeutic directions

Hansbro

Horvat

Wark

2008

Pharmacology & Therapeutics

114

113

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Asthma is a common and debilitating disease that has substantially increased in prevalence in Western Societies in the last 2 decades. Respiratory tract infections by respiratory syncytial virus (RSV) and rhinovirus (RV) are widely implicated as common causes of the induction and exacerbation of asthma. These infections in early life are associated with the induction of wheeze that may progress to the development of asthma. Infections may also promote airway inflammation and enhance T helper type 2 lymphocyte (Th2 cell) responses that result in exacerbations of established asthma. The mechanisms of how RSV and RV induce and exacerbate asthma are currently being elucidated by clinical studies, in vitro work with human cells and animal models of disease. This research has led to many potential therapeutic strategies and, although none are yet part of clinical practise, they show much promise for the prevention and treatment of viral disease and subsequent asthma.

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Section: Icss and Long Acting Beta Agonists (Labas)mentioning

confidence: 99%

Understanding the mechanisms of viral induced asthma: New therapeutic directions

Hansbro

Horvat

Wark

2008

Pharmacology & Therapeutics

114

113

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“…Thus, recent guidelines from the British Thoracic Society state that patients on a daily ICS dose as low as 200 mg can benefit from additional longacting b 2 -agonists (17). Moreover, in persistent asthma, longacting b 2 -agonists coupled with ICS are more effective than increasing the dose of ICS (18,19,23,25,26), and the use of b 2 -agonists is now well established (27,28).…”

Section: U R R E N T a S T H M A G U I D E L I N E Smentioning

confidence: 99%

The asthma management gap - why current treatment strategies can fail to provide optimal asthma control

Fabbri

Boulet

Kardos

et al. 2004

International Journal of Clinical Practice

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Summary Standard asthma management strategies are not always successful at providing optimal control. Despite the availability of effective asthma drugs and the publication of numerous asthma management guidelines, many patients are not adequately controlled and experience frequent asthma symptoms and exacerbations. Current guidelines advocate a stepwise approach to treatment, initially through inhaled corticosteroids, with the addition of a long‐acting β2‐agonist or another asthma medication when required. Once asthma control has been achieved with an appropriate starting dose, corticosteroids should be reduced to the lowest effective dose with the option to step up during periods of asthma worsening. Such strategies require personalised, written action plans to enable patients to make appropriate changes in medication with less requirement for intervention by the physician. Adjustable maintenance dosing with budesonide/formoterol in a single inhaler offers an effective means to adapt the medication to the needs of the patient, as indicated in the current guidelines.

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“…nhaled corticosteroids are the mainstay of asthma therapy, but there is now compelling evidence that addition of a long-acting inhaled b 2 -agonist (LABA; salmeterol or formoterol) gives better control in terms of reduced symptoms, improved lung function and reduced exacerbations in patients with mild, moderate and severe persistent asthma than increasing the dose of corticosteroids in patients not fully controlled on low doses [1][2][3][4][5]. This has led to the development of fixed combination inhalers, fluticasone/salmeterol (Seretide2/Advair2, GlaxoSmithKline), and budesonide/formoterol (Symbicort1, AstraZeneca), which are now increasingly used in asthma management [6,7].…”

mentioning

confidence: 99%

Scientific rationale for using a single inhaler for asthma control

Barnes¹

2007

European Respiratory Journal

138

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Clinical trials have recently demonstrated that using a budesonide/formoterol combination inhaler as regular maintenance treatment twice daily but also as a rescue therapy for breakthrough symptoms can provide more effective control of asthma, particularly in reducing exacerbations, than using a short-acting b 2 -agonist or formoterol as rescue therapy. This suggests that the corticosteroid component of the combination therapy plays an important role in rescue therapy.Formoterol as a rescue therapy is effective in relieving symptoms by relaxing airway smooth muscle but is also likely to have important inhibitory effects on mast cells, plasma exudation and neutrophilic inflammation.Inhaled corticosteroids have much more rapid suppressing effects on airway inflammation than previously recognised and the increased dose used as rescue therapy may prevent the increase in airway inflammation that occurs during the evolution of an exacerbation, thus preventing its development.It is likely that the molecular interactions between b 2 -agonists and corticosteroids also enhance the effect of the combination therapy as rescue therapy. There is now a strong scientific rationale for single inhaler therapy in asthma, but more research is now needed to better understand the mechanisms involved.

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Long-acting beta2-agonists for stable chronic asthma

Cited by 25 publications

References 216 publications

Understanding the mechanisms of viral induced asthma: New therapeutic directions

Understanding the mechanisms of viral induced asthma: New therapeutic directions

The asthma management gap - why current treatment strategies can fail to provide optimal asthma control

Scientific rationale for using a single inhaler for asthma control

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