Антихолинергические препараты в лечении хронической обструктивной болезни легких: фокус на тиотропий
Аннотация
В последние несколько лет наблюдается лавинообразный рост числа новых лекарственных препаратов и их комбинаций, предлагаемых для лечения больных хронической обструктивной болезнью легких (ХОБЛ), что, с одной стороны, увеличивает терапевтические возможности, с другой – затрудняет выбор лучших из имеющихся. До настоящего времени бронходилататоры остаются ведущим направлением фармакотерапии ХОБЛ, а монотерапия антихолинергическими препаратами (АХП) или их комбинация с другими лекарственными средствами (β2-агонисты длительного действия, глюкокортикоиды, рофлумиласт) – едва ли не наиболее востребованный лечебный подход у данной категории больных. Подобное утверждение базируется главным образом на беспримерных доказательствах эффективности и безопасности применения тиотропия бромида (ТБ) – прототипа длительно действующих АХП, опыт успешного клинического применения которого составляет свыше 10 лет. Во многом именно репутацией ТБ стимулирован результативный поиск других длительно действующих АХП, которые в настоящее время являются одним из наиболее активно разрабатываемых и высокоэффективных классов лекарственных препаратов для лечения ХОБЛ. Очевидно, что у новых АХП база данных по оценке их клинической эффективности и безопасности ограничена, представлена исследованиями III фазы и потому не отражает в полной мере реальную популяцию больных ХОБЛ и не позволяет рассматривать их в качестве безусловной альтернативы ТБ.
Об авторе
А. И. Синопальников
ГБОУ ДПО "Российская медицинская академия последипломного образования" Минздрава России: 123995, Москва, ул. Баррикадная, 2 / 1
Россия
Россия
д. м. н., профессор, зав. кафедрой пульмонологии ГБОУ ДПО "Российская медицинская академия последипломного образования" Минздрава России; тел.: (495) 263-53-72
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Для цитирования:
Синопальников А.И. Антихолинергические препараты в лечении хронической обструктивной болезни легких: фокус на тиотропий. Пульмонология. 2014;(6):73-82. https://doi.org/10.18093/0869-0189-2014-0-6-73-82
For citation:
Sinopal'nikov A.I. Anticholinergics for therapy of chronic obstructive pulmonary disease: focus on tiotropium. Russian Pulmonology. 2014;(6):73-82. (In Russ.) https://doi.org/10.18093/0869-0189-2014-0-6-73-82
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