Bedoradrine for treating asthma and chronic obstructive pulmonary disease

In severe asthma attacks or in severe chronic obstructive pulmonary disease (COPD) exacerbations, inhaled short-acting bronchodilators, such as salbutamol (albuterol), terbutaline or ipratropium, often have a limited effectiveness due to significantly impaired ventilation. For these reasons, the use of a systemic bronchodilator medication might be more appropriate as therapeutic options. However, such formulations, especially salbutamol, are usually, and unfortunately, associated with a high risk of cardiovascular events. For this reason, they are only seldom used, especially in the case of paediatric populations.

This drug evaluation paper reviews the potential therapeutic agent bedoradrine, an ultraselective β2 agonist, which is currently under development for treating exacerbated asthma and COPD. The article includes a review of both in vitro and in vivo studies as well as a review of the pharmacokinetics, efficacy, safety and tolerability.

The intravenous use of bedoradrine has demonstrated promising preliminary efficacy in existing clinical trials for exacerbated asthma. However, the efficacy of bedoradrine is still uncertain in exacerbated COPD. Further clinical studies should assess the efficacy and safety of bedoradrine as an add-on therapy to usual standardised approach and exacerbation-related variables should be used as outcome measures.