pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2015-25-1-93-100pulmo-530Research ArticleОБЗОРЫREVIEWЗначение фиксированных комбинаций длительно действующих антихолинергических препаратов и длительно действующих #b2-агонистов в терапии хронической обструктивной болезни легкихA role of fixed combinations of long-acting anticholinergics and long-acting #b2-agonists in therapy of chronic obstructive pulmonary diseaseАвдеевС. Н.AvdeevS. N.

д. м. н., проф., руководитель клинического отдела ФГБУ «НИИ пульмонологии» ФМБА России; тел. / факс: (495) 465-52-64;

MD, Professor, Head of Clinical Department, Federal State Federal Institution «Pulmonology Research Institute», Federal Medical and Biological Agency of Russia; tel.: (495) 465-52-64;

serg_avdeev@list.ruФГБУ «НИИ пульмонологии» ФМБА России: 105077, Москва, ул. 11-я Парковая, 32, корп. 4РоссияFederal Institution «Pulmonology Research Institute», Federal Medical and Biological Agency of Russia: 32, build. 4, 11th Parkovaya ul., Moscow, 105077, RussiaRussian Federation20153004201525193100Copyright © Авдеев С.Н., 20152015Авдеев С.Н.Avdeev S.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/530

Терапия фиксированными комбинациями длительно действующих антихолинергических препаратов (ДДАХП) и длительно действующих #b2-агонистов (ДДБА) на основе индакатерола и гликопиррония характеризуется высокой клинической эффективностью по сравнению с монокомпонентами препарата. По результатам проведенных клинических исследований подтверждена фармакологическая концепция о синергичном потенцировании бронхорасширяющего эффекта при использовании препаратов с разными механизмами действия, каковыми являются ДДБА и ДДАХП. Важно, что достижение дополнительного терапевтического эффекта возможно без повышения риска развития нежелательных явлений. Все это является основанием для заключения, что при совместном назначении индакатерола и гликопиррония оптимизируется и производит максимальный эффект бронходилатация у многих пациентов с хронической обструктивной болезнью легких (ХОБЛ), у которых не достигается адекватного улучшения бронхиальной проходимости при использовании лишь одного бронходилататора. При комбинированной терапии индакатеролом и гликопирронием (препарат QVA149) у пациентов c ХОБЛ значительно улучшаются клинические симптомы, легочная функция, качество жизни, снижается число обострений.

Treatment with fixed combinations of a long-acting anticholinergic (LAMA) glycopyrronium and a long-acting #b2-agonist (LABA) indacaterol is characterized by high clinical efficacy when compared to single components. Published results of clinical trials are in line with the pharmacological theory about synergy of bronchodilators with different mechanisms of action such as LAMA and LABA. Importantly, an additional therapeutic effect could be achieved without increasing risk of adverse events. This allows conclusion that administration of indacaterol and glycopyrronium could achieve the optimal and maximal bronchodilation in most patients with chronic obstructive pulmonary disease (COPD) who fail to improve bronchial obstruction with a single bronchodilator. A combined therapy with indacaterol and glycopyrronium (QVA149) was shown to significantly improve clinical symptoms, lung function, quality of life and decrease in number of exacerbations in COPD patients.

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The authors declare that there are no conflicts of interest present.