title: Why use long acting bronchodilators in chronic obstructive lung diseases? An extensive review on formoterol and salmeterol.
abstract: Long-acting β2-adrenoceptor agonists, formoterol and salmeterol, represent a milestone in the treatments of chronic obstructive lung diseases. Although no specific indications concerning the choice of one molecule rather than another are provided by asthma and COPD guidelines, they present different pharmacological properties resulting in distinct clinical employment possibilities. In particular, salmeterol has a low intrinsic efficacy working as a partial receptor agonist, while formoterol is a full agonist with high intrinsic efficacy. From a clinical perspective, in the presence of low β2-adrenoceptors availability, like in inflamed airways, a full agonist can maintain its bronchodilatory and non-smooth muscle activities while a partial agonist may be less effective. Furthermore, formoterol presents a faster onset of action than salmeterol. This phenomenon, combined with the molecule safety profile, leads to a prompt amelioration of the symptoms, and allows using this drug in asthma as an "as needed" treatment in patients already on regular treatment. The fast onset of action and the full agonism of formoterol need to be considered in order to select the best pharmacological treatment of asthma and COPD.
authors.affiliation: Dipartimento di Scienze della Salute. Pneumologia Riabilitativa Fondazione Salvatore Maugeri, Istituto Scientifico di Milano-IRCCS. Università degli Studi di Milano, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Santus
authors.affiliation: Dipartimento di Scienze della Salute. Pneumologia Riabilitativa Fondazione Salvatore Maugeri, Istituto Scientifico di Milano-IRCCS. Università degli Studi di Milano, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Radovanovic
authors.affiliation: Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Paggiaro
authors.affiliation: Respiratory Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Papi
authors.affiliation: Section of Respiratory Diseases, Department of Surgery and Clinical Medicine, University of Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Sanduzzi
authors.affiliation: Department of Internal Medicine, Section of Pulmonology (DIBIMIS), University of Palermo, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Scichilone
authors.affiliation: Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCS AOU San Martino-IST, Genoa, Italy. Electronic address: fulvio.braido@unige.it.
authors.forename: F
authors.initials: F
authors.lastname: Braido
mesh_terms: D001993:Bronchodilator Agents / Q000627:therapeutic use*; D000068759:Formoterol Fumarate / Q000627:therapeutic use*; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D000068299:Salmeterol Xinafoate / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D000068299:Salmeterol Xinafoate; D000068759:Formoterol Fumarate
keywords: Asthma; Chronic obstructive pulmonary disease; Formoterol; LABA; Salmeterol