title: Pharmacological basis and scientific rationale underlying the targeted use of inhaled corticosteroid/long-acting β2-adrenergic agonist combinations in chronic obstructive pulmonary disease treatment.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a complex respiratory disorder, whose medical and socioeconomic burden as one of the main causes of morbidity and mortality is increasing worldwide. COPD pathophysiology includes chronic airway/lung inflammation and progressive airflow limitation. Therefore, anti-inflammatory and bronchodilator agents are key players in COPD treatment.
  
  
  METHODS
  This review article discusses the complementary molecular interactions connecting the respective mechanisms of action of inhaled corticosteroids (ICS) and long-acting β2-adrenergic agonists (LABAs). Moreover, attention is also focused on clinical trials, which have shown that ICS/LABA combinations are very effective in improving COPD symptoms and lung function, being also able to significantly reduce disease exacerbations.
  
  
  CONCLUSIONS
  In selected subgroups of COPD patients, ICS/LABA combinations represent a very useful therapeutic approach for this widespread chronic respiratory disease. In addition to the well-known fixed-dose drug associations such as fluticasone propionate/salmeterol xinafoate and budesonide/formoterol fumarate, other newly developed ICS/LABA combinations are currently emerging as very interesting pharmacological options for COPD treatment.
authors.affiliation: University 'Magna Græcia' of Catanzaro, Department of Medical and Surgical Sciences, Section of Respiratory Diseases , Catanzaro , Italy.
authors.forename: Girolamo
authors.initials: G
authors.lastname: Pelaia
authors.forename: Carmelo Caio
authors.initials: CC
authors.lastname: Muzzio
authors.forename: Alessandro
authors.initials: A
authors.lastname: Vatrella
authors.forename: Rosario
authors.initials: R
authors.lastname: Maselli
authors.forename: Maria Sandra
authors.initials: MS
authors.lastname: Magnoni
authors.forename: Andrea
authors.initials: A
authors.lastname: Rizzi
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D018450:Disease Progression; D004359:Drug Therapy, Combination; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents
keywords: chronic obstructive pulmonary disease; clinical trials; inhaled corticosteroids; long-acting β2-adrenergic agonists; molecular interactions