Abdurrahman ŞENYİĞİT, Cengizhan SEZGİ

KOAH’da yeni tedavi seçeneği: Fosfodiesteraz-4 inhibitörleri

Kronik obstrüktif akciğer hastalığı (KOAH) ilerleyici hava akımı kısıtlanması ile karakterize, zararlı gaz ve tozlara karşı abartılı inflamatuvar yanıtla ortaya çıkan bir hastalıktır. İnflamatuvar hücrelerin aktivasyonunu engelleyen oral fosfodiesteraz- 4 (FDE-4) inhibitörleri son yıllarda KOAH tedavisinde yeni bir yaklaşım olarak denenmektedir. Çalışmalar FDE-4 inhibitörlerinin orta-ağır KOAH hastalarının semptomlarını, solunum fonksiyonlarını ve yaşam kalitesini düzelttiğini, akut atak sayısını azalttığını, bronşlardaki inflamasyonu baskıladığını göstermiştir. Ancak bu ilaçlar bulantı, ishal ve baş ağrısı gibi istenmeyen yan etkilere neden olmaktadır. Bu derlemede özellikle “Food and Drug Administration (FDA)” onayı almış, yeni “The Global Initiative for Chronic Obstructive Lung Disease (GOLD)” rehberinde ağır KOAH tedavisine dahil edilmiş selektif bir fosfodiesteraz inhibitörü olan roflumilast tartışılmıştır.

A new alternative treatment in COPD: phosphodiesterase-4 inhibitors

Chronic obstructive pulmonary disease (COPD) is a disease which is characterized with progressive airflow obstruction and abnormal inflammatory response caused by noxious gases and particles. Recently oral phosphodiesterase-4 (PDE-4) inhibitors which block activation of inflammatory cells, are experimented as a new approach. Last studies showed that these drugs improve symptoms, pulmonary functions and quality of life, reduce the numbers of acute attacks, suppress bronchial inflammation in COPD. However these drugs lead to adverse reactions such as vomiting, diarrhea and headache. In this review we discussed roflumilast (Daxas) which was accepted by Food and Drug Administration (FDA), included in treatment of sever COPD in “The Global Initiative for Chronic Obstructive Lung Disease (GOLD)” guideline.

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