PharmatecaPharmatecaФарматека2073-40342414-9128Bionika Media31314210.18565/pharmateca.2021.5.43-52ArticlesСтатьиResearch ArticleBronchodilator therapy for COPD: a 20-year roadБронходилатирующая терапия ХОБЛ: дорога длиною в 20 летSinopalnikovAleksandr I.СинопальниковА. И

Dr. Sci. (Med.), Professor, Head of the Department of Pulmonology

д.м.н., профессор, зав. кафедрой пульмонологии

aisyn@list.ruRussian Medical Academy of Continuous Professional EducationРоссийская медицинская академия непрерывного профессионального образования15052021285VOL 28, NO5 (2021)ТОМ 28, №5 (2021)435203032023Copyright ©; 2021, Bionika MediaCopyright ©; 2021, ООО «Бионика Медиа»2021Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/2073-4034/article/view/313142

The article discusses the problem of bronchodilator therapy for chronic obstructive pulmonary disease (COPD). The choice of bronchodilators as a priority in the treatment of patients with COPD is justified by their numerous sanogenetic effects, achieved mainly by a direct stimulating effect on β2-adrenergic receptors and indirectly by blocking the effect of acetylcholine on muscarinic cholinergic receptors (cholinergic blockers or anticholinergic drugs).

В статье обсуждается проблема бронходилатирующей терапии хронической обструктивной болезни легких (ХОБЛ). Выбор бронходилататоров в качестве приоритетного направления лечения больных ХОБЛ аргументируется их многочисленными саногенетическими эффектами, достигаемыми главным образом прямым стимулирующим действием на β2-адренорецепторы и непрямым - посредством блокады влияния ацетилхолина на мускариновые холинорецепторы (холиноблокаторы или антихолинергические препараты).

chronic obstructive pulmonary diseaselong-acting β-agonistslong-acting anticholinergicsхроническая обструктивная болезнь легкихдлительно действующие β-агонистыдлительно действующие холиноблокаторыLenfant C. Preface to the 2001 GOLD Report. In: Pauwels R.A., Buist A.S., Calverley P.M., Jenkins C.R., Hurd S.S. Global strategy for the diagnosis, management, and prevention of chronic pulmonary disease. NHLBI/WEHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med. 2001;163:1256-76Berry P.D., Dhand R. Inhalation Therapy for Stable COPD: 20 Years of GOLD Reports. Adv Ther. 2020;37:1812-28. Doi: 10.1007/s12325-020-01289-y.Cazzola M., Page C.P., Calzetta L., et al. Pharmacology and therapeutics of bronchodilators. Pharmacol Rev. 2012;64:450-504. Doi: 10.1124/pr.111.004580.Williams D.M., Rubin B.K. Clinical pharmacology of bronchodilator medications. Respir Care. 2018;63:641-54. Doi: 10.4187/ respcare.06051.Johnson M., Rennard S. Alternative mechanisms for long-acting beta(2)-adrenergic agonists in COPD. Chest. 2001;120:258-70. Doi: 10.1378/ chest.120.1.258.Hanania N.A., Moore R.H. Anti-inflammatory activities of beta2-agonists. Curr Drug Targets Inflamm Allergy. 2004;3:271-77. Doi: 10.2174/1568010043343598.Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management and Prevention of COPD, 2021. Available from: http://goldcopd.org/gold- 2021-global-strategy-diagnosis-management-prevention-copd/.Miravitlles M., Soler-Cataluna J.J., Calle M., et al. Spanish guidelines for management of chronic obstructive pulmonary disease (GesEPOC) 2017: pharmacological treatment of stable phase. Arch Bronconeumol. 2017;53:324-35. Doi: 10.1016/j.arbres.2017.03.018.Aisanov Z., Avdeev S., Arkhipov V., et al. Russian guidelines for the management of COPD: algorithm of pharmacologic treatment. Int J COPD. 2018;13:183-87. Doi: 10.2147/COPD. S153770.Cazzola M., Molimard M. The scientific rationale for combining long-acting beta-2-agonists and muscarinic antagonists in COPD. Pulm Pharmacol Ther. 2010;23:257-67. Doi: 10.1016/j. pupt.2010.03.003.Miravitlles M., Baek S., Vithlani V., Lad R. Optimal bronchodilation for COPD patients: are all long-acting ß2-agonist/long-acting muscarinic antagonists the same? Tuberc Respir Dis. 2018;81:198-215. Doi: 10.4046/ trd.2018.0040.Price D., Östrem A., Thomas M., Welte T. Dual bronchodilation in COPD: lung function and patient-reported outcomes - a review. Int J COPD. 2017;12:141-68. Doi: 10.2147/COPD. S116719.Rodrigo G.J., Price D., Anzueto A., et al. LABA/ LAMA combination versus monotherapy or LABA/ ICS in COPD: a systematic review and meta-analysis. Int J COPD. 2017;12:907-22. Doi: 10.2147/COPD.S130482.Takahashi T., Ichinose M., Inoue H., et al. Underdiagnosis and undertreatment of COPD in primary care settings. Respirol. 2003;8:504-8. Doi: 10.1046/j.1440-1843.2003.00501.x.Zaas D., Wise R., Wiener C. Longcope Spirometry Investigation Team. Airway obstruction is common but unsuspected in patients admitted to a general medicine service. Chest. 2014;125:106-11. Doi: 10.1378/chest.125.1.106.Tantucci C., Modina D. Lung function decline in COPD. Int J Chron Obstruct Pulmon. Dis. 2012;7:95-9. doi: 10.2147/COPD.S27480.Troosters T., Sciurba F.C., Decramer M., et al. Tiotropium in patients with moderate COPD naive to maintenance therapy: a randomised placebocontrolled trial. NPJ Prim Care Respir Med. 2014;24:14003. Doi: 10.1038/npjpcrm.2014.3.Covvey J.R., Mullen A.B., Ryan M., et al. A comparison of medication adherence/persistence for asthma and chronic obstructive pulmonary disease in the United Kingdom. Int J Clin Pract. 2014;68:1200-208. Doi: 10.1111/ijcp.12451.Asai K., Hirata K., Hashimoto S., et al. Efficacy and safety of indacaterol/glycopyrronium in Japanese patients with COPD: pooled analysis of SHINE and ARISE. Respir Investig. 2016;54:428-35. Doi: 10.1016/j.resinv.2016.06.006.Bateman E.D., Ferguson G.T., Barnes N., et al. Dual bronchodilation with QVA149 versus single bronchodilator therapy: the SHINE study. Eur Respir J. 2013;42:1484-94. Doi: 10.1183/09031936.00200212.Wedzicha J.A., Decramer M., Ficker J.H., et al. Analysis of chronic obstructive pulmonary disease exacerbations with the dual bronchodilator QVA149 compared with glycopyrronium and tiotropium (SPARK): a randomised, doubleblind, parallel-group study. Lancet Respir Med. 2013;1:199-209. Doi: 10.1016/S2213-2600(13)70052-3.Muro S., Yoshisue H., Kostikas K., et al. Indacaterol/glycopyrronium versus tiotropium or glycopyrronium in long-acting bronchodilator-naïve COPD patients: A pooled analysis. Respirol. 2020;25:393-400. Doi: 10.1111/resp.13651.Wedzicha J.A., Banerji D., Chapman K.R., et al. Indacaterol-glycopyrronium versus salmeterol-fluticasone for COPD. N Engl J Med. 2016;374:2222-34. Doi: 10.1056/ NEJMoa1516385.Anzueto A.R., Kostikas K., Mezzi K., et al. Indacaterol/glycopyrronium versus salmeterol/ fluticasone in the prevention of clinically important deterioration in COPD: results from the FLAME study. Respir Res. 2018;19:121. Doi: 10.1186/ s12931-018-0830-z.Mammen M.J., Lloyd D.R., Kumar S., et al. Triple therapy versus dual or monotherapy with long-acting bronchodilators for COPD: A systematic review and meta-analysis. Ann Am Thorac Soc. 2020;17(10):1308-18. Doi: 10.1513/ AnnalsATS.202001-023OC.Bafadhel M., Peterson S., De Blas M.A., et al. Predictors of exacerbation risk and response to budesonide in patients with chronic obstructive pulmonary disease: a post-hoc analysis of three randomised trials. Lancet Respir Med. 2018;6:117-26. Doi: 10.1016/S2213-2600(18)30006-7.Gibson P.G. Variability of blood eosinophils as a biomarker in asthma and COPD. Respirol. 2018;23:12-3. Doi: 10.1111/resp.13200.Feldman G.J., Sousa A.R., Lipson D.A., et al. Comparative efficacy of once-daily umeclidinium/ vilanterol and tiotropium/olodaterol therapy in symptomatic chronic obstructive pulmonary disease: a randomized study. Adv Ther. 2017;34:2518-33. Doi: 10.1007/s12325-017-0626-4.Rogliani P., Calzetta L., Braido F., et al. LABA/LAMA fixed-dose combinations in patients with COPD: a systematic review. Int J Chron Obstruct Pulmon Dis. 2018;13:3115-30. Doi: 10.2147/COPD. S170606.Cazzola M., Matera M.G., Donner C.F. Inhaled ß2-Adrenoceptor Agonists Cardiovascular Safety in Patients with Obstructive Lung Disease. Drugs. 2005;65:1595-610. Doi: 10.2165/00003495200565120-00001.Brodde O.E. Beta1- and beta2-adrenoceptors in the human heart: properties, function, and alterations in chronic heart failure. Pharmacol Rev. 1991;43:203-42.Newton G.E., Parker J.D. Acute effects of beta1-selective and nonselective beta-adrenergic receptor blockade on cardiac sympathetic activity in congestive heart failure. Circulation. 1996;94:353-58. Doi: 10.1161/01. cir.94.3.353.Salpeter S.R., Ormiston T.M., Salpeter E.E. Cardiovascular effects of beta-agonists in patients with asthma and COPD: a meta-analysis. Chest. 2004;125:2309-21. Doi: 10.1378/ chest.125.6.2309.Sears M.R. Adverse effects of beta-agonists. J Allergy Clin Immunol. 2002;110(Suppl. 6):S322-Doi: 10.1067/mai.2002.129966.Cazzola M., Calzetta L., Matera M.G. The cardiovascular risk of tiotropium: is it real? Expert Opin Drug Saf. 2010;9:783-92. Doi: 10.1517/14740338.2010.500611.Yang B., Lin H., Xu C., et al. Choline produces cytoprotective effects against ischemic myocardial injuries: evidence for the role of cardiac m3 subtype muscarinic acetylcholine receptor. Cell Physiol Biochem. 2005;16:163- 74. Doi: 10.1159/000089842.Shi H., Wang H., Lu Y., et al. Choline modulates cardiac membrane repolarization y activating an M3 muscarinic receptor and its coupled K+ channel. J Membr Biol. 1999;169:55-64. Doi: 10.1007/pl00005901.Rogliani P., Calzetta L., Matera M.G., et al. Inhaled therapies and cardiovascular risk in patients with chronic obstructive pulmonary disease. Expert Opin Pharmacother. 2019;20:737-50. Doi: 10.1080/14656566.2019.1570133.Vestbo J., Anderson J.A., Brook R.D., et al. Fluticasone furoate and vilanterol and survival in chronic obstructive pulmonary disease with heightened cardiovascular risk (SUMMIT): a double-blind randomised controlled trial. Lancet. 2016;387(10030):1817-26. Doi: 10.1016/ S0140-6736(16)30069-1.Buhl R., Magder S., Bothner U., et al. Long-term general and cardiovascular safety of tiotropium/ olodaterol in patients with moderate to very severe chronic obstructive pulmonary disease. Respir Med. 2017;122:58-66. Doi: 10.1016/j. rmed.2016.11.011.Hohlfeld J.M., Vogel-Claussen J., Biller H., et al. Effect of lung deflation with indacaterol plus glycopyrronium on ventricular filling in patients with hyperinflation and COPD (CLAIM): a doubleblind, randomised, crossover, placebocontrolled, single-centre trial. Lancet Respir Med. 2018; 6:368-78. Doi: 10.1016/S2213-2600(18) 30054-7.Calzetta L., Matera M.G., Cazzola M. Pharmacological mechanisms leading to synergy in fixed-dose dual bronchodilator therapy. Curr Opin Pharmacol. 2018;40:95-103. Doi: 10.1016/j. coph.2018.03.011.Calzetta L., Rogliani P., Matera M.G., et al. A systematic review with meta-analysis of dual bronchodilation with LAMA/LABA for the treatment of stable COPD. Chest. 2016;149:1181-96. Doi: 10.1016/j.chest.2016.02.646.Rogliani P., Matera M.G., Ora J., et al. The impact of dual bronchodilation on cardiovascular serious adverse events and mortality in COPD: a quantitative synthesis. Int J Chron Obstruct Pulmon Dis. 2017;12:3469-85. Doi: 10.2147/COPD. S146338.Chow A.H., Tong H.H., Chattopadhyay P., Shekunov B.Y Particle engineering for pulmonary drug delivery. Pharm Res. 2007;24:411-37. Doi: 10.1007/s11095-006-9174-3.Chapman K.R., Fogarty C.M., Peckitt C., et al. Delivery characteristics and patients' handling of two single-dose dry-powder inhalers used in COPD. int J Chron Obstruct Pulmon Dis. 2011;6:353-63. Doi: 10.2147/COPD.S18529.Colthorpe P., Voshaar T., Kiekbusch T., et al. 2013. Delivery characteristics of a low-resistance dry-powder inhaler used to deliver the long-acting muscarinic antagonist glycopyrronium. J Drug Assess. 2013;2:11-6. Doi: 10.3109/21556660.2013.766197.Lavorini F., Fontana G.A., Usmani O.S. New inhaler devices - the good, the bad and the ugly. Respiration. 2014;88:3-15. Doi: 10.1159/000363390.Riley C.M., Sciurba F.C. Diagnosis and Outpatient Management of Chronic Obstructive Pulmonary Disease. A Review. JAMA. 2019;321:786-97. Doi: 10.1001/jama.2019.0131.Molimard M., Colthorpe P inhaler devices for chronic obstructive pulmonary disease: insights from patients and healthcare practitioners. J Aerosol Med Pulm Drug Deliv. 2015;28:219-28. Doi: 10.1089/jamp.2014.1142.Dolovicha M.B., Kuttlerb A., Dimkeb T.J., Usmanic O.S. Biophysical model to predict lung delivery from a dual bronchodilator dry powder inhaler. int J Pharm. 2019;1:100018. Doi: 10.1016/j. ijpx.2019.100018.Pavkov R., Mueller S., Fiebich K., et al. Characteristics of a capsule based dry powder inhaler for the delivery of indacaterol. Curr Med Res Opin. 2010;26:2527-33. Doi: 10.1185/03007995.2010.518916.Molimard M., Raherison C., Lignot S., et al. Chronic obstructive pulmonary disease exacerbation and inhaler device handling: real-life assessment of 2935 patients. Eur Respir J. 2017;49:1601794. Doi: 10.1183/13993003. 01794-2016.