Why use long acting bronchodilators in chronic obstructive lung diseases? An extensive review on formoterol and salmeterol

P. Santus, D. Radovanovic, P. Paggiaro, A. Papi, A. Sanduzzi, N. Scichilone, F. Braido

Research output: Contribution to journalReview article

Abstract

Abstract Long-acting β2-adrenoceptor agonists, formoterol and salmeterol, represent a milestone in the treatments of chronic obstructive lung diseases. Although no specific indications concerning the choice of one molecule rather than another are provided by asthma and COPD guidelines, they present different pharmacological properties resulting in distinct clinical employment possibilities. In particular, salmeterol has a low intrinsic efficacy working as a partial receptor agonist, while formoterol is a full agonist with high intrinsic efficacy. From a clinical perspective, in the presence of low β2-adrenoceptors availability, like in inflamed airways, a full agonist can maintain its bronchodilatory and non-smooth muscle activities while a partial agonist may be less effective. Furthermore, formoterol presents a faster onset of action than salmeterol. This phenomenon, combined with the molecule safety profile, leads to a prompt amelioration of the symptoms, and allows using this drug in asthma as an "as needed" treatment in patients already on regular treatment. The fast onset of action and the full agonism of formoterol need to be considered in order to select the best pharmacological treatment of asthma and COPD.

Original languageEnglish (US)
Article number2924
Pages (from-to)379-384
Number of pages6
JournalEuropean Journal of Internal Medicine
Volume26
Issue number6
DOIs
StatePublished - Jul 1 2015

Keywords

  • Asthma
  • Chronic obstructive pulmonary disease
  • Formoterol
  • LABA
  • Salmeterol

ASJC Scopus subject areas

  • Internal Medicine

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