Abstract
Recently, there is a progressive growth in new drugs and combinations for treatment of chronic obstructive pulmonary disease (COPD) that, on the one hand, promotes therapeutic opportunities but, on the other hand, impedes the best choice of the drug. Bronchodilators have been still the cornerstone of the pharmacotherapy of COPD. Anticholinergics as monotherapy or in combination with other drugs, such as long - acting beta - 2 - agonists, inhaled steroids, or roflumilast, are widespread therapeutic approach for these patients. A huge body of evidence has been accumulated about the safety and efficacy of long - acting anticholinergic tiotropium bromide which has been successfully used worldwide for more than 10 years. Longacting anticholinergics are one of the most actively developed and highly efficient drugs for management of COPD. There is limited evidence regarding clinical efficacy and safety of novel anticholinergics mostly obtained from phase III clinical trials which did not involve the real - life population of COPD patients; this fact prevents considering new long - acting anticholinergics as a definitive alternative for tiotropium bromide.
Highlights
there is a progressive growth in new drugs and combinations for treatment
A huge body of evidence has been accumulated about the safety and efficacy of long acting anticholinergic tiotropium bromide
limited evidence regard ing clinical efficacy and safety of novel anticholinergics mostly obtained from phase III clinical trials
Summary
There is a progressive growth in new drugs and combinations for treatment of chronic obstructive pulmonary disease (COPD) that, on the one hand, promotes therapeutic opportunities but, on the other hand, impedes the best choice of the drug. A huge body of evidence has been accumulated about the safety and efficacy of long acting anticholinergic tiotropium bromide which has been successfully used worldwide for more than 10 years. There is limited evidence regard ing clinical efficacy and safety of novel anticholinergics mostly obtained from phase III clinical trials which did not involve the real life population of COPD patients; this fact prevents considering new long acting anticholinergics as a definitive alternative for tiotropium bromide. А так же более привлекательным профилем безопасности АХП [20, 21] объясняется предпочтение практикую щих врачей, отдаваемое данным препаратам при вы боре стартовой терапии ХОБЛ [22]
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