Long-acting beta-adrenoceptor agonist
Long-acting beta-adrenoceptor agonist | |
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In Wikidata |
Long-acting β adrenoceptor agonists (LABAs) are
Medical uses
When combined with inhaled steroids, β adrenoceptor agonists can improve symptoms.[1][2] In children this benefit is uncertain and they may be potentially harmful.[2] They should not be used without an accompanying steroid due to an increased risk of severe symptoms, including exacerbation in both children and adults.[3] A 2018 meta-analysis was unable to determine whether an increase serious adverse events reported in the previous meta-analysis on regular salmeterol alone is abolished by the additional use of regular inhaled corticosteroid.[4] Large surveillance studies are ongoing to provide more information. There were no asthma-related deaths and few asthma-related serious adverse events when salmeterol is used with an inhaled steroid.[5][6] At least with formoterol, an increased risk appears to be present even when steroids are used[7] and this risk has not been ruled out for salmeterol.[8]
Agents
Some of the currently available long-acting β2 adrenoceptor agonists include:
International nonproprietary name (INN): Trade (brand) name
- arformoterol: Brovana (some consider it to be an ultra-LABA)[9]
- bambuterol: Bambec, Oxeol
- clenbuterol: Dilaterol, Spiropent
- formoterol: Foradil, Oxis, Perforomist
- salmeterol: Serevent
- protokylol: Ventaire
Ultra-LABAs
Several long-acting β adrenoreceptor agonists have a duration of action of 24 hours, allowing for once-daily dosing. They are considered to be ultra-long-acting β adrenoreceptor agonists (ultra-LABAs)[10] and are now approved.
- indacaterol: approved by the European Medicines Agency (EMA) on November 30, 2009,[11] and by Russian FDA-equivalent under the trade name Onbrez Breezhaler. In the United States. it was approved by the Food and Drug Administration (FDA) under the trade name Arcapta Neohaler on July 1, 2011)[12]
- olodaterol: approved in some European countries and Russia, and by the U.S. Food and Drug Administration (FDA) on July 31, 2014, under Striverdi Respimat[13]
- vilanterol is the ultra-LABA not available by itself but only as a component of combination drugs:
- with fluticasone furoate: Breo Ellipta (U.S.), Relvar Ellipta (EU, RU). This second medication in this combination is the synthetic inhaled corticosteroid fluticasone furoate. This product was approved by the FDA in May 2013 as once-daily inhaled therapy for the treatment of chronic obstructive pulmonary disease (COPD)
- with umeclidinium bromide: Anoro Ellipta. Umeclidinium bromide is a long-acting muscarinic antagonist.[14] This combination was approved by the FDA on December 18, 2013[15] for the long-term maintenance treatment of COPD. On March 28, 2014, it was approved in European countries[16] and in Russia[17] under the same trade name.
Ultra-LABAs under development
This section needs to be updated.(February 2020) |
- abediterol (codenamed LAS100977)[18][19]
- salmefamol (salbutamol and para-methoxyamphetamine (PMA) hybrid)[citation needed]
Failed agents
- carmoterol (formerly TA-2005):[19] development terminated[20]
- PF-610355: development terminated[21]
Concerns
A meta-analysis study from 2006 (pooled results of 19 trials, 33,826 participants) raised concerns that
References
- PMID 21769507.
- ^ PMID 20464739.
- PMID 19264689.
- PMID 30521673.
- PMID 18646149.
- ^ "FDA Drug Safety Communication: New safety requirements for long-acting inhaled asthma medications called Long-Acting Beta-Agonists (LABAs)". U.S. Food and Drug Administration (FDA). Feb 2010. Archived from the original on 2017-11-02. Retrieved 2019-12-16.
Based on the available information, FDA concludes there is an increased risk for severe exacerbation of asthma symptoms, leading to hospitalizations in pediatric and adult patients as well as death in some patients using LABAs for the treatment of asthma. The agency is requiring the REMS and class-labeling changes to improve the safe use of these products.
- PMID 22513944.
- PMID 18646149.
- S2CID 46976912. Retrieved 7 March 2016.
- S2CID 11930383.
- ^ European Public Assessment Report for Onbrez Breezhaler Archived 2010-01-16 at the Wayback Machine
- ^ "FDA approves Arcapta Neohaler to treat chronic obstructive pulmonary disease" (Press release). U.S. Food and Drug Administration (FDA). 2011-07-01. Archived from the original on 2011-07-03. Retrieved 2011-07-02.
- ^ "New once-daily Striverdi (olodaterol) Respimat gains approval in first EU countries". Boehringer-Ingelheim. 18 October 2013.
- ^ "Incruse Ellipta (umeclidinium inhalation powder) for Oral Inhalation Use. Full Prescribing Information" (PDF). GlaxoSmithKline, Research Triangle Park, NC 27709. Archived from the original (PDF) on 10 July 2018. Retrieved 22 February 2016.
- ^ "FDA approves Anoro Ellipta to treat chronic obstructive pulmonary disease". U.S. Food and Drug Administration (FDA). Archived from the original on 24 March 2016. Retrieved 25 March 2016.
- ^ "Assessment report: Anoro. INN: umeclidinium bromide/vilanterol" (PDF). European Medicines Agency. Retrieved 25 March 2016.
- ^ "State Register of Nedicines: Anoro Ellipta (vilanterol + umeclidinium bromide)". Russian State Register of Medicinal Products (in Russian). Retrieved 25 March 2016.
- PMID 25256258. Retrieved 25 March 2016.
- ^ PMID 21232045.)
{{cite journal}}
: CS1 maint: numeric names: authors list (link - ^ "Chiesi: Annual Report 2010" (PDF). Chiesi Farmaceutici S.p.A. p. 20. Retrieved 27 March 2016.
- ^ "AdisInsight: PF 610355". Springer International Publishing AG. Retrieved 25 March 2016.
- S2CID 30648411.
- ^ Krishna Ramanujan (June 9, 2006). "Common asthma inhalers cause up to 80 percent of asthma-related deaths, Cornell and Stanford researchers assert". ChronicalOnline - Cornell University.
- ^ "Safety Alerts for Human Medical Products > Long-Acting Beta-Agonists (LABAs): New Safe Use Requirements". U.S. Food and Drug Administration (FDA). Archived from the original on 22 March 2016. Retrieved 25 March 2016.
- ^ "FDA Drug Safety Communication: FDA review finds no significant increase in risk of serious asthma outcomes with long-acting beta agonists (LABAs) used in combination with inhaled corticosteroids (ICS)". U.S. Food and Drug Administration (FDA). 9 February 2019.