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Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma

Published on: November 4, 2010

Levalbuterol for asthma: a better treatment?

H William Kelly¹

¹Department of Pediatrics, Pediatrics/Pulmonary, MSC10-5590, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA. hwkelly@salud.unm.edu

Current Allergy and Asthma Reports

|June 6, 2007

Summary

Current research indicates that levalbuterol, a single-isomer asthma medication, may not offer significant advantages over racemic albuterol. More data is needed to confirm benefits for specific patient groups.

Area of Science:

Pharmacology
Respiratory Medicine
Clinical Trials

Background:

Levalbuterol, the (S)-enantiomer of albuterol, is used for asthma treatment.
In vitro studies suggest (S)-albuterol has proinflammatory actions.
Racemic albuterol contains both (R) and (S) enantiomers.

Purpose of the Study:

To evaluate if the in vitro proinflammatory effects of (S)-albuterol translate to a clinical advantage for levalbuterol over racemic albuterol.
To synthesize evidence from clinical trials on the efficacy of levalbuterol versus racemic albuterol in asthma.

Main Methods:

Systematic review of clinical trials comparing levalbuterol and racemic albuterol.
Analysis of studies investigating bronchodilation in chronic and acute asthma.

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Assessment of in vitro and animal model data regarding (S)-albuterol's effects.

Main Results:

Clinical trial evidence on levalbuterol's advantage is conflicting.
Older trials suggested a benefit, but newer trials have not confirmed this.
In vitro findings of increased bronchial hyperresponsiveness with (S)-albuterol are not consistently replicated in clinical settings.

Conclusions:

Current clinical trials do not demonstrate a substantial therapeutic advantage of levalbuterol over racemic albuterol.
The heterogeneity of existing trials prevents definitive conclusions.
Further research is required to identify potential patient subsets that may benefit from single-isomer therapy.