Ultra Long-Acting β-Agonists in Chronic Obstructive Pulmonary Disease
Robert M Burkes,1,2 Ralph J Panos1,2 1University of Cincinnati Division of Pulmonary, Critical Care, and Sleep Medicine, Cincinnati, OH, USA; 2Department of Pulmonary, Critical Care, and Sleep Medicine, Cincinnati Veterans’ Affairs Medical Center, Cincinnati, OH, USACorrespondence: Ralph J...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-12-01
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| Series: | Journal of Experimental Pharmacology |
| Subjects: | |
| Online Access: | https://www.dovepress.com/ultra-long-acting-beta-agonists-in-chronic-obstructive-pulmonary-disea-peer-reviewed-fulltext-article-JEP |
| _version_ | 1819029238653648896 |
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| author | Burkes RM Panos RJ |
| author_facet | Burkes RM Panos RJ |
| author_sort | Burkes RM |
| collection | DOAJ |
| description | Robert M Burkes,1,2 Ralph J Panos1,2 1University of Cincinnati Division of Pulmonary, Critical Care, and Sleep Medicine, Cincinnati, OH, USA; 2Department of Pulmonary, Critical Care, and Sleep Medicine, Cincinnati Veterans’ Affairs Medical Center, Cincinnati, OH, USACorrespondence: Ralph J PanosCincinnati Veterans’ Affairs Medical Center, 3200 Vine Street, Cincinnati, OH 45220, USATel +1 513-861-3100 x 7002Email ralph.panos@va.govIntroduction: Inhaled β-agonists have been foundational medications for maintenance COPD management for decades. Through activation of cyclic adenosine monophosphate pathways, these agents relax airway smooth muscle and improve expiratory airflow by relieving bronchospasm and alleviating air trapping and dynamic hyperinflation improving breathlessness, exertional capabilities, and quality of life. β-agonist drug development has discovered drugs with increasing longer durations of action: short acting (SABA) (4– 6 h), long acting (LABA) (6– 12 h), and ultra-long acting (ULABA) (24 h). Three ULABAs, indacaterol, olodaterol, and vilanterol, are approved for clinical treatment of COPD.Purpose: This article reviews both clinically approved ULABAs and ULABAs in development.Conclusion: Indacaterol and olodaterol were originally approved for clinical use as monotherapies for COPD. Vilanterol is the first ULABA to be approved only in combination with other respiratory medications. Although there are many other ULABA’s in various stages of development, most clinical testing of these novel agents is suspended or proceeding slowly. The three approved ULABAs are being combined with antimuscarinic agents and corticosteroids as dual and triple agent treatments that are being tested for clinical use and efficacy. Increasingly, these clinical trials are using specific COPD clinical characteristics to define study populations and to begin to develop therapies that are trait-specific.Keywords: chronic obstructive pulmonary disease, COPD, β-agonist, long-acting β-agonist, LABA, ultra long-acting β-agonist, ULABA |
| first_indexed | 2024-12-21T06:11:05Z |
| format | Article |
| id | doaj.art-d35e75bedfb54f8ba74f531837a06645 |
| institution | Directory Open Access Journal |
| issn | 1179-1454 |
| language | English |
| last_indexed | 2024-12-21T06:11:05Z |
| publishDate | 2020-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Experimental Pharmacology |
| spelling | doaj.art-d35e75bedfb54f8ba74f531837a066452022-12-21T19:13:32ZengDove Medical PressJournal of Experimental Pharmacology1179-14542020-12-01Volume 1258960260273Ultra Long-Acting β-Agonists in Chronic Obstructive Pulmonary DiseaseBurkes RMPanos RJRobert M Burkes,1,2 Ralph J Panos1,2 1University of Cincinnati Division of Pulmonary, Critical Care, and Sleep Medicine, Cincinnati, OH, USA; 2Department of Pulmonary, Critical Care, and Sleep Medicine, Cincinnati Veterans’ Affairs Medical Center, Cincinnati, OH, USACorrespondence: Ralph J PanosCincinnati Veterans’ Affairs Medical Center, 3200 Vine Street, Cincinnati, OH 45220, USATel +1 513-861-3100 x 7002Email ralph.panos@va.govIntroduction: Inhaled β-agonists have been foundational medications for maintenance COPD management for decades. Through activation of cyclic adenosine monophosphate pathways, these agents relax airway smooth muscle and improve expiratory airflow by relieving bronchospasm and alleviating air trapping and dynamic hyperinflation improving breathlessness, exertional capabilities, and quality of life. β-agonist drug development has discovered drugs with increasing longer durations of action: short acting (SABA) (4– 6 h), long acting (LABA) (6– 12 h), and ultra-long acting (ULABA) (24 h). Three ULABAs, indacaterol, olodaterol, and vilanterol, are approved for clinical treatment of COPD.Purpose: This article reviews both clinically approved ULABAs and ULABAs in development.Conclusion: Indacaterol and olodaterol were originally approved for clinical use as monotherapies for COPD. Vilanterol is the first ULABA to be approved only in combination with other respiratory medications. Although there are many other ULABA’s in various stages of development, most clinical testing of these novel agents is suspended or proceeding slowly. The three approved ULABAs are being combined with antimuscarinic agents and corticosteroids as dual and triple agent treatments that are being tested for clinical use and efficacy. Increasingly, these clinical trials are using specific COPD clinical characteristics to define study populations and to begin to develop therapies that are trait-specific.Keywords: chronic obstructive pulmonary disease, COPD, β-agonist, long-acting β-agonist, LABA, ultra long-acting β-agonist, ULABAhttps://www.dovepress.com/ultra-long-acting-beta-agonists-in-chronic-obstructive-pulmonary-disea-peer-reviewed-fulltext-article-JEPchronic obstructive pulmonary disease (copd)beta agonistlong acting beta-agonist (laba)ultra long acting beta-agonist (ulaba) |
| spellingShingle | Burkes RM Panos RJ Ultra Long-Acting β-Agonists in Chronic Obstructive Pulmonary Disease Journal of Experimental Pharmacology chronic obstructive pulmonary disease (copd) beta agonist long acting beta-agonist (laba) ultra long acting beta-agonist (ulaba) |
| title | Ultra Long-Acting β-Agonists in Chronic Obstructive Pulmonary Disease |
| title_full | Ultra Long-Acting β-Agonists in Chronic Obstructive Pulmonary Disease |
| title_fullStr | Ultra Long-Acting β-Agonists in Chronic Obstructive Pulmonary Disease |
| title_full_unstemmed | Ultra Long-Acting β-Agonists in Chronic Obstructive Pulmonary Disease |
| title_short | Ultra Long-Acting β-Agonists in Chronic Obstructive Pulmonary Disease |
| title_sort | ultra long acting beta agonists in chronic obstructive pulmonary disease |
| topic | chronic obstructive pulmonary disease (copd) beta agonist long acting beta-agonist (laba) ultra long acting beta-agonist (ulaba) |
| url | https://www.dovepress.com/ultra-long-acting-beta-agonists-in-chronic-obstructive-pulmonary-disea-peer-reviewed-fulltext-article-JEP |
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