Long-Acting Muscarinic Antagonists for Difficult-to-Treat Asthma: Emerging Evidence and Future Directions

被引:0
作者
Adeeb Bulkhi
Farnaz Tabatabaian
Thomas B. Casale
机构
[1] University of South Florida,Division of Allergy and Immunology, Department of Internal Medicine
[2] Umm Al-Qura University,Department of Internal Medicine, College of Medicine
来源
Drugs | 2016年 / 76卷
关键词
Asthma; Chronic Obstructive Pulmonary Disease; Peak Expiratory Flow; Tiotropium; Tiotropium Bromide;
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学科分类号
摘要
Asthma is a complex disease where many patients remain symptomatic despite guideline-directed therapy. This suggests an unmet need for alternative treatment approaches. Understanding the physiological role of muscarinic receptors and the parasympathetic nervous system in the respiratory tract will provide a foundation of alternative therapeutics in asthma. Currently, several long-acting muscarinic antagonists (LAMAs) are on the market for the treatment of respiratory diseases. Many studies have shown the effectiveness of tiotropium, a LAMA, as add-on therapy in uncontrolled asthma. These studies led to FDA approval for tiotropium use in asthma. In this review, we discuss how the neurotransmitter acetylcholine itself contributes to inflammation, bronchoconstriction, and remodeling in asthma. We further describe the current clinical studies evaluating LAMAs in adult and adolescent patients with asthma, providing a comprehensive review of the current known physiological benefits of LAMAs in respiratory disease.
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页码:999 / 1013
页数:14
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共 225 条
[1]  
Wechsler ME(2014)Getting control of uncontrolled asthma Am J Med. 127 1049-1059
[2]  
Bel EH(2004)Clinical phenotypes of asthma Curr Opin Pulm Med. 10 44-50
[3]  
Fahy JV(2015)Type 2 inflammation in asthma—present in most, absent in many Nat Rev Immunol. 15 57-65
[4]  
Guyer AC(2013)Long-acting anticholinergics in the treatment of asthma Curr Opin Allergy Clin Immunol. 13 392-398
[5]  
Long AA(2012)Pharmacology and therapeutics of bronchodilators Pharmacol Rev. 64 450-504
[6]  
Cazzola M(2014)Is there a rationale and role for long-acting anticholinergic bronchodilators in asthma? NPJ Primary Care Respir Med. 24 14023-1068
[7]  
Page CP(1997)Muscarinic control of airway function Life Sci. 60 1061-323
[8]  
Calzetta L(2013)A new perspective on muscarinic receptor antagonism in obstructive airways diseases Curr Opin Pharmacol. 13 316-1571
[9]  
Matera MG(2006)Muscarinic receptor signaling in the pathophysiology of asthma and COPD Respir Res. 7 73-351
[10]  
Price D(2008)Acetylcholine beyond neurons: the non-neuronal cholinergic system in humans Br J Pharmacol. 154 1558-201