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Subsensibilidad al broncodilatador al salbutamol después de tomar salmeterol dos veces al día en pacientes asmáticos
1Department of Clinical Pharmacology, Ninewells Hospital, University of Dundee, UK.
Lancet (London, England)
|July 22, 1995
Resumen
El uso continuo de salmeterol puede atenuar la respuesta del broncodilatador al salbutamol en pacientes con asma. Este estudio encontró una reducción de las respuestas y la densidad de los adrenoceptores beta-2 con salmeterol, a pesar de mantener el control de la enfermedad.
Área de la Ciencia:
- Farmacología Farmacología.
- Medicina de las vías respiratorias Medicina de las vías respiratorias
- Los ensayos clínicos son ensayos clínicos.
Sus antecedentes:
- Existen preocupaciones con respecto al uso regular de agonistas beta-2 en el manejo del asma.
- Los agonistas beta-2 de acción prolongada (LABA) como el salmeterol se utilizan cada vez más.
- El impacto de la exposición continua a LABA en la respuesta aguda al broncodilatador necesita ser evaluado.
Objetivo del estudio:
- Evaluar si la administración continua de salmeterol dos veces al día disminuye la respuesta broncodilatadora aguda al salbutamol.
- Para investigar los cambios en la densidad de los adrenoceptores beta-2 con el tratamiento con salmeterol.
- Para evaluar la efectividad del salmeterol en el control del asma durante el tratamiento.
Principales métodos:
- Estudio doble ciego, controlado con placebo y cruzado en 17 pacientes con asma.
- Los pacientes recibieron salmeterol 50 mcg dos veces al día o placebo durante 4 semanas.
- Se midieron las curvas de desafío de la histamina y de respuesta a la dosis de salbutamol (FEV1, PEFR).
Principales resultados:
- El tratamiento con salmeterol redujo significativamente las respuestas broncodilatadoras al salbutamol en comparación con el placebo.
- Se necesitó una dosis de salbutamol 2,5 y 4 veces mayor para obtener mejoras en FEV1 y PEFR, respectivamente.
- La densidad de los adrenoceptores beta-2 de los linfocitos disminuyó significativamente después de tomar salmeterol.
Conclusiones:
- El uso continuo de salmeterol puede atenuar el efecto broncodilatador agudo del salbutamol.
- La reducción de la densidad de los adrenorreceptores beta-2 puede ser la causa de esta respuesta embotada.
- El salmeterol mantuvo el control del asma, evidenciado por una mejora en el PEFR matutino.
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