Medicamentos beta-agonistas de larga acción: perfil de riesgo-beneficio en pacientes con asma

Long-acting beta agonists: a risk-benefit profile in patients with asthm

Publicado 2010-06-01

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Vol. 22 Núm. 2 (2010)
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Medicamentos beta-agonistas de larga acción: perfil de riesgo-beneficio en pacientes con asma.
rev. colomb. neumol. [Internet]. 2010 Jun. 1 [cited 2024 Dec. 11];22(2):37-41.
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Rodolfo J Dennis
MD, MSc, PhDc. Director Departamentos de Medicina Interna e Investigaciones, Fundación Cardioinfantil. Profesor Titular de Medicina, Universidad Javeriana. Bogotá, Colombia.
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    Existe evidencia que muestra que pacientes asmáticos con exposición a broncodilatadores beta-agonistas de larga acción (BALA), en quienes no se garantiza el tratamiento controlador anti-inflamatorio simultáneo con corticoides inhalados (ICS), pueden presentar eventos de empeoramiento del asma muy infrecuentes, pero severos y potencialmente mortales. No es claro si este hallazgo puede ser debido a eventos adversos asociados con el mecanismo de acción de los BALA, o a enmascaramiento de la severidad del asma. No existe evidencia derivada de experimentos clínicos en seres humanos que sugiera que pacientes con exposición a BALA, en quienes se garantiza el tratamiento controlador anti-inflamatorio simultáneo con ICS, puedan presentar eventos severos de empeoramiento del asma potencialmente mortales. De igual forma, tampoco hay evidencia conclusiva de presencia de riesgo derivada de meta-análisis y de estudios observacionales. Desafortunadamente, tampoco existe evidencia conclusiva de ausencia de riesgo. El juicio de valor que se le asigna al balance de riesgo-beneficio de los BALA+CSI puede variar entre médicos, pacientes, reguladores, y epidemiólogos. Este balance ha sido discutido extensamente. En general, hay consenso que este balance está a favor de mantener disponible las combinaciones de BALA+CSI para los pacientes con
    asma. En esta revisión se enuncian las principales recomendaciones con respecto a su utilización, basadas en la evidencia actual. 

     

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