AUMENTO DE MORTALIDADE COM O USO DO FENOTEROL EM ASMA: EVIDENCIA HISTORICA SUFICIENTE PARA DISCUTIR SUAS INDICAÇOES NO BRASIL?

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Com as evidências vigentes, a utilização irrestrita de fenoterol em asma deveria ser discutida por especialistas, sociedades médicas e órgãos governamentais no Brasil.
Autor:
Andrea m Rodrigues
Columnista Experto de SIIC

Institución:
Pontificia Universidade Católica do Rio Grande do Sul


Artículos publicados por Andrea m Rodrigues
Coautor
Emerson r da Silva* 
Universidade de Caxias do Sul, Caxias do Sul, Brasil*
Recepción del artículo
29 de Abril, 2013
Aprobación
25 de Junio, 2013
Primera edición
1 de Abril, 2013
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
O objetivo do presente artigo é analisar e discutir as publicações referentes à associação de aumento de mortalidade com o uso de fenoterol no tratamento de asma, seus efeitos colaterais e a situação atual de sua utilização em asma no mundo e no Brasil. Como fonte de dados, foi utilizada a base de dados do PubMed, utilizando os descritores asthma AND fenoterol, e Scielo, utilizando os descritores asma e fenoterol. São apresentados os resultados de estudos relevantes realizados sobre o tema em alguns países desenvolvidos e discutimos o potencial risco aumentado de mortalidade em pacientes que utilizam fenoterol em asma. Vários estudos demonstraram também a menor seletividade deste fármaco aos receptores 2-adrenérgicos. A comercialização de fenoterol foi proibida ou restrita em inúmeros países desenvolvidos, mas é amplamente utilizada ainda no Brasil. Os autores concluem que, com as evidências vigentes, a utilização irrestrita deste fármaco em asma deveria ser discutida por especialistas, sociedades médicas e órgãos governamentais no Brasil.

Palabras clave
mortalidade, terapêutica, broncodilatador


Artículo completo

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Abstract
The aim of the present article is to analyze and discuss the papers published regarding the association between the increase in asthma mortality and the use of fenoterol, its adverse effects and the current situation of its use in asthma in developed countries and in Brazil. As source of data, PubMed and Scielo databases were used, and a search was made with asthma AND fenoterol as keywords, for the selection of relevant articles. We have presented the results from studies made in developed countries and we discuss the potential increased risk of death in patients using fenoterol in asthma. Many studies have also demonstrated that fenoterol is less selective to b2-agonist receptors. Fenoterol use has been restricted or prohibited in many developed countries, but it is still widely used in Brazil. The authors conclude that, given the current evidence, the restricted use of fenoterol in asthma should be discussed by specialists, medical societies and government agencies in Brazil.

Key words
mortality, therapeutics, bronchodilator agents


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Medicina Farmacéutica, Neumonología
Relacionadas: Administración Hospitalaria, Atención Primaria, Farmacología, Medicina Familiar, Medicina Interna



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Enviar correspondencia a:
Paulo M Pitrez, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil
Bibliografía del artículo
1. Braman SS. The global burden of asthma. Chest 130(1 Suppl):4S-12S, 2006.
2. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Lancet 351(9111):1225-32, 1998.
3. Pereira MU, Sly PD, Pitrez PM, Jones MH, Escouto D, Dias AC, et al. Nonatopic asthma is associated with helminth infections and bronchiolitis in poor children. Eur Respir J 29(6):1154-60, 2007.
4. DATASUS - Ministério da Saúde do Brasil. 2010 [cited 2011 11/04]; available from: http://tabnet.datasus.gov.br.
5. Global Initiative for Asthma. Global strategy for asthma management and prevention. 2009 [cited 2011 11/04]; available from: http://www.ginasthma.org.
6. Crane J, Pearce N, Burgess C, Beasley R. Asthma and the beta agonist debate. Thorax 50 Suppl 1:S5-10, 1995.
7. Crane J, Pearce N, Flatt A, Burgess C, Jackson R, Kwong T, et al. Prescribed fenoterol and death from asthma in New Zealand, 1981-83: case-control study. Lancet 1(8644):917-22, 1989.
8. Pearce N, Grainger J, Atkinson M, Crane J, Burgess C, Culling C, et al. Case-control study of prescribed fenoterol and death from asthma in New Zealand, 1977-81. Thorax 45(3):170-5, 1990.
9. Grainger J, Woodman K, Pearce N, Crane J, Burgess C, Keane A, et al. Prescribed fenoterol and death from asthma in New Zealand, 1981-7: a further case-control study. Thorax 46(2):105-11, 1991.
10. Tandon MK. Cardiopulmonary effects of fenoterol and salbutamol aerosols. Chest 77(3):429-31, 1980.
11. Wong CS, Pavord ID, Williams J, Britton JR, Tattersfield AE. Bronchodilator, cardiovascular, and hypokalaemic effects of fenoterol, salbutamol, and terbutaline in asthma. Lancet 336(8728):1396-9, 1990.
12. Bremner P, Burgess CD, Crane J, McHaffie D, Galletly D, Pearce N, et al. Cardiovascular effects of fenoterol under conditions of hypoxaemia. Thorax 47(10):814-7, 1992.
13. Pearce N. The use of beta agonists and the risk of death and near death from asthma. J Clin Epidemiol 62(6):582-7, 2009.
14. Beasley R, Pearce N, Crane J, Burgess C. Beta-agonists: what is the evidence that their use increases the risk of asthma morbidity and mortality? J Allergy Clin Immunol 104(2 Pt 2):S18-30, 1999.
15. Jalba MS. Three generations of ongoing controversies concerning the use of short acting beta-agonist therapy in asthma: a review. J Asthma 45(1):9-18, 2008.
16. Jackson RT, Beaglehole R, Rea HH, Sutherland DC. Mortality from asthma: a new epidemic in New Zealand. Br Med J (Clin Res Ed) 285(6344):771-4, 1982.
17. Spitzer WO, Buist AS. Case-control study of prescribed fenoterol and death from asthma in New Zealand, 1977-81. Thorax 45(8):645-6, 1990.
18. Pearce N, Beasley R, Crane J, Burgess C, Jackson R. End of the New Zealand asthma mortality epidemic. Lancet 345(8941):41-4, 1995.
19. Spitzer WO, Suissa S, Ernst P, Horwitz RI, Habbick B, Cockcroft D, et al. The use of beta-agonists and the risk of death and near death from asthma. N Engl J Med 326(8):501-6, 1992.
20. Suissa S, Ernst P, Boivin JF, Horwitz RI, Habbick B, Cockroft D, et al. A cohort analysis of excess mortality in asthma and the use of inhaled beta-agonists. American journal of respiratory and critical care medicine. [Research Support, Non-U.S. Gov't] 149(3 Pt 1):604-10, 1994.
21. Garrett JE, Lanes SF, Kolbe J, Rea HH. Risk of severe life threatening asthma and beta agonist type: an example of confounding by severity. Thorax 51(11):1093-9, 1996.
22. Beasley R, Nishima S, Pearce N, Crane J. Beta-agonist therapy and asthma mortality in Japan. Lancet 351(9113):1406-7, 1998.
23. Windom HH, Burgess CD, Siebers RW, Purdie G, Pearce N, Crane J, et al. The pulmonary and extrapulmonary effects of inhaled beta-agonists in patients with asthma. Clin Pharmacol Ther 48(3):296-301, 1990.
24. Lipworth BJ, Newnham DM, Clark RA, Dhillon DP, Winter JH, McDevitt DG. Comparison of the relative airways and systemic potencies of inhaled fenoterol and salbutamol in asthmatic patients. Thorax 50(1):54-61, 1995.
25. Newhouse MT, Chapman KR, McCallum AL, Abboud RT, Bowie DM, Hodder RV, et al. Cardiovascular safety of high doses of inhaled fenoterol and albuterol in acute severe asthma. Chest 110(3):595-603, 1996.
26. Bremner P, Siebers R, Crane J, Beasley R, Burgess C. Partial vs full beta-receptor agonism. A clinical study of inhaled albuterol and fenoterol. Chest 109(4):957-62, 1996.
27. Boehringer Ingelheim do Brasil. Boehringer Ingelheim do Brasil. Nosso Negócio - Cronologia da Boehringer Ingelheim do Brasil. 2011 [cited 2011 11/04]; available from: http://www.boehringer-ingelheim.com.br.
28. Sociedade Brasileira de Pneumologia e Tisiologia. Sociedade Brasileira de Pneumologia e Tisiologia. IV Diretrizes Brasileiras para o Manejo da Asma. 1996 [cited 2011 11/04].
29. British Thoracic Society - Scottish Intercollegiate Guidelines Network. British Thoracic Society - Scottish Intercollegiate Guidelines Network. British Guideline on the Management of Asthma - A national clinical guideline. May 2008 - revised June 2009 [cited 2011 11/04]; available from: http://www.sign.ac.uk/guidelines/published/numlist.html.
30. National Heart Lung and Blood Institute - National Asthma Education and Prevention Program. National Heart Lung and Blood Institute - National Asthma Education and Prevention Program. Guidelines for the Diagnosis and Management of Asthma. 2007 [cited 2011 11/04]; available from: http://www.nhlbi.nih.gov/guidelines/asthma/.

 
 
 
 
 
 
 
 
 
 
 
 
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