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Pharmacokinetic considerations surrounding triple therapy for uncontrolled asthma
Maria Gabriella Matera1, Barbara Rinaldi1, Carmela Belardo1
1Unit of Pharmacology, Department of Experimental Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy.
Expert Opinion on Drug Metabolism & Toxicology
|June 28, 2023
Summary
Triple therapy with inhaled corticosteroids, long-acting β2-agonists, and long-acting muscarinic antagonists is effective for severe asthma. Pharmacokinetics are largely unaffected by severe asthma, with clinical response guiding therapy.
Area of Science:
- Pharmacology
- Respiratory Medicine
- Clinical Pharmacy
Background:
- Triple therapy (inhaled corticosteroid, long-acting β2-agonist, long-acting muscarinic antagonist) is recommended for severe asthma.
- This combination improves lung function, symptoms, and reduces exacerbations.
Purpose of the Study:
- To examine pharmacokinetic issues of triple therapy in uncontrolled asthma.
- To assess the influence of inhalers and severe asthma on drug pharmacokinetics.
Main Methods:
- Literature review of pharmacokinetic characteristics of the three drug classes.
- Analysis of the role of inhalers in pharmacokinetic behavior.
- Evaluation of severe asthma's impact on inhaled drug pharmacokinetics.
Main Results:
- Severe asthma minimally affects the pharmacokinetics of inhaled corticosteroids and bronchodilators.
- Observed pharmacokinetic variations in severe asthma patients are unlikely to be clinically significant.
- Difficulty in obtaining complete pharmacokinetic profiles necessitates monitoring clinical response.
Conclusions:
- Pharmacokinetics of triple therapy components are generally stable in severe asthma.
- Clinical response serves as a reliable indicator of adequate drug concentration and efficacy.
- No specific pharmacokinetic adjustments are typically required for triple therapy in severe asthma.
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