Bülent ŞEKEREL, Gül KARAKAYA, Füsun YILDIZ, Arzu YORGANCIOĞLU, Haluk TÜRKTAŞ

Astım tedavisinde uzun etkili beta-2 agonistlerin yeri ve güvenilirliği

Günümüzde astım tedavisinin temelini inhaler steroidler oluşturur. Tek başına inhaler steroidler ile kontrol altına alınamayan astımlı hastalarda tedavide ilk seçenek, uzun etkili beta-2 agonistlerin eklenmesidir. Yaklaşık 20 yıldır bu yaklaşımın etkin bir tedavi olduğu kabul edilmektedir. Ancak kullanılmaya başlandığı ilk günden beri uzun etkili beta-2 agonist ilaçların güvenilirliği konusunda tartışmalar yaşanmaktadır. Güvenilirliği konusunda birçok makale ve öneri yayınlanmıştır. Kanıtlar, hasta uyumunu artırmak ve uzun etkili beta-2 agonist ilaçların tek başına kullanılmasını önlemek için inhaler steroidler ile birlikte tek bir cihazda (fiks kombinasyon) kullanılmasını desteklemektedir. Bu derlemede, astım tedavisinde uzun etkili beta-2 agonist kullanımı ve güvenilirliği konusundaki veriler değerlendirilmiş ve yorumlanmıştır.

Long acting beta-2 agonists in the treatment of asthma and their safety

Inhaled corticosteroids are the preferred primary long-term treatment for asthma. The first option in patients who are uncontrolled with inhaled steroids is adding long-acting beta-2 agonists. The addition of a long-acting beta-agonist to an inhaled corticosteroid has been accepted as effective therapy for almost two decades Despite the widespread use and their clinical benefit, controversy regarding their safety arose after their introduction. Concerns about the safety of long-acting beta-2 agonist therapy, has led to the appearance of multiple publications and recommendations. The evidence supports the use of long-acting beta-2 agonists plus inhaled corticosteroids in a single inhaler device to increase adherence and reduce the potential use of long-acting beta-2 agonists monotherapy. This review examines and commands on the available clinical data and safety concerns of long-acting beta-2 agonists use in patients with asthma.

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