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Pneumologie 2000; 54(8): 345-354
DOI: 10.1055/s-2000-6955
ÜBERSICHT
Georg Thieme Verlag Stuttgart · New York

Von der Pathophysiologie zu neuen Entwicklungen in der Pharmakotherapie des Asthma bronchiale - ein Blick in die Zukunft

A. Gillissen, H. Schäfer, S. Tasci, S. Ewig
  • Medizinische Klinik und Poliklinik II, Bonn
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Publication History

Publication Date:
31 December 2000 (online)

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Einleitung

Die Therapie des Asthma bronchiale lehnt sich zunehmend an die pathophysiologischen Grundlagen dieser Erkrankung an und basiert auf drei wichtigen Ansätzen: der Meidung auslösender Faktoren, der antiinflammatorischen und der antiobstruktiven Pharmakotherapie. Therapeutisches Ziel ist: a) die Erhaltung/Verbesserung der Lebensqualität, b) die Steigerung der Lungenfunktion mit Unterbindung von u. U. lebensbedrohlichen Asthmaanfällen, c) damit die Vermeidung von irreversiblen Umbauvorgängen (remodelling), bei d) gleichzeitiger Minimierung von Nebenwirkungen in der Langzeittherapie.

Neuere in Deutschland zugelassene Substanzen und Applikationsformen betreffen den Leukotrienrezeptorantagonisten Montelukast, das Kombinationspräparat Salmeterol/Fluticasondipropionat und ein mittels HFA (Hydroflouralkan) betriebenes BDP (Beclomethasondipropionat)-haltiges Dosieraerosol, das durch einen hohen Anteil respirabler Partikel (Partikelgröße < 3 μm = > 30 %) eine hohe pulmonale Deposition (> 50 %) gewährleistet [[1] [2] [3] [4] [5]]. Weitere inhalative Kombinationspräparate (z. B. Formoterol/Budesonid) und andere Glukokortikosteroide (Mometason-Furoat, Triamcinolonacetonid, Ciclesonid) werden wahrscheinlich in naher Zukunft folgen [[6], [7]]. Die jüngste Entwicklung therapeutischer Substanzen zur Behandlung des Asthma bronchiale imponiert daher durch die Etablierung neuer Kombinationspräparate oder durch die Modifizierung pharmakokinetischer/-dynamischer Eigenschaften schon etablierter Substanzen.

Die vorliegende Übersicht soll anhand der aktuellen Literatur und der jüngst auf internationalen Kongressen vorgestellten Arbeiten einen Überblick über die Entwicklung in der Pharmakotherapie des Asthma bronchiale geben.

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Prof. Dr. med A Gillissen

Medizinische Klinik und Poliklinik II Rheinische Friedrich-Wilhelms-Universität Bonn

Sigmund-Freud-Str. 25 53105 Bonn

Email: E-mail: adrian.gillissen@meb.uni-bonn.de

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