Because of the central role of bronchodilators in the treatment of asthma, in recent years there has been a renewed interest in the field and now once-daily bronchodilators are in development in an attempt to simplify their use.
A variety of β2-agonists with long half-lives, also called ultra long-acting β2-agonists (ultra-LABAs; indacaterol, carmoterol, milveterol, GSK-642444, BI-1744-CL, LAS-100977, and PF-00610355) are currently under development with the hopes of achieving once-daily dosing. Between them, indacaterol, GSK-642444, and carmoterol are at a more advanced stage of development. Also several novel inhaled long-acting antimuscarinic agents are currently being developed, but their role in the treatment of asthma is limited. As combination therapy with an inhaled corticosteroid (ICS) and a LABA is considered the first-line approach for treating patients suffering from asthma, some novel once-daily combinations of LABAs and ICSs are under development.
Bronchodilators are central in the symptomatic management of asthma. It is likely that the once-daily dosing of a bronchodilator would be a significant convenience and probably a compliance-enhancing advantage, leading to improved overall clinical outcomes in patients with asthma. In any case, as a LABA in combination with an ICS continues to be the most effective asthma treatment, once-daily combinations of ultra-LABAs and ICSs will be central in the treatment of asthmatic patients in the next years.
aDepartment of Internal Medicine, Unit of Respiratory Clinical Pharmacology, University of Rome ‘Tor Vergata’, Rome, Italy
bDepartment of Experimental Medicine, Unit of Pharmacology, 2nd University of Naples, Naples, Italy
Correspondence to Professor Mario Cazzola, Dipartimento di Medicina Interna, Facoltà di Medicina e Chirurgia, Università di Roma ‘Tor Vergata’, Via Montpellier 1, 00133 Rome, Italy E-mail: firstname.lastname@example.org