Ipratropium
Ipratropium
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Produkter
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Atrovent, Atrovent Nasal, Combivent, Ipramol, Ipratropium/Salbutamol O......
Atrovent, Atrovent Nasal, Combivent, Ipramol, Ipratropium/Salbutamol Orion, Ipratropium/Salbutamol Sandoz, Ipratropiumbromid Arrow, Ipravent, Ipraxa, Itrop, Rinivent, Salipra, SapimolATC-koder
R01AX03, R03AL02, R03BB01
R01AX03, R03AL02, R03BB01Substanser
ipratropium, ipratropiumbromid, ipratropiumbromid (monohydrat)
ipratropium, ipratropiumbromid, ipratropiumbromid (monohydrat)Sammanfattning
Större kontrollerade studier med analyser avseende könsskillnader i behandlingseffekter saknas. En post-hoc-analys på KOL-patienter visade bättre effekt hos kvinnor. Två mindre studier på astmapatienter visade motsägande resultat vad gäller skillnader i effekt mellan könen. Akut urinretention har rapporterats i högre grad hos män.
Sämre inhalationsteknik har visats hos kvinnor vid användning av vissa inhalatorer, vilket kan ha betydelse för god effekt av läkemedlet, men detta har inte studerats i tillräcklig utsträckning.
Background
COPD (chronic obstructive pulmonary disease) affects more women than men, and women often get a more serious and rapidly progressive disease [1]. Data from various studies indicate that women have increased dyspnea for a given level of airflow limitation and greater airway hyper-responsiveness, as well as greater frequency of exacerbations [2]. Visa hela bakgrundstexten
Childhood asthma is more common in boys while adult asthma is more common in women. The reversal of this sex difference in prevalence occurs around puberty which suggests that sex hormones may play a role in the etiology of asthma [3]. However, some studies suggest that there are sex differences in expression and diagnosing of asthma, and whether women are under-treated for respiratory diseases or not has been discussed [4,5].
A systematic review of 32 studies on sex differences in adult asthma and COPD therapy concludes inconsistent evidence concerning sex-related response to treatment [6].
Pharmacokinetics and dosing
No studies with a clinically relevant sex analysis regarding the pharmacokinetics and dosing of ipratropium were found.
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Försäljning på recept
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Fler kvinnor än män hämtade ut inhalationsspray eller lösning för nebulisator innehållande ipratropium (ATC-kod R03BB01) på recept i Sverige år 2023, totalt 5 223 kvinnor och 3 141 män. Det motsvarar 1,0 respektive 0,6 personer per tusen invånare. Andelen som hämtade ut läkemedel var högst i åldersgruppen 70 år och äldre hos båda könen. Totalt sett var inhalationsspray eller lösning för nebulisator innehållande ipratropium 1,7 gånger vanligare hos kvinnor [16]. Något fler män hämtade ut nässpray innehållande ipratropium (ATC-kod R01AX03) på recept i Sverige år 2023, totalt 3 240 män och 3 072 kvinnor. Det motsvarar 0,6 respektive 0,6 personer per tusen invånare. Andelen som hämtade ut läkemedel var högst i åldersgruppen 70 år och äldre hos båda könen. I åldersgruppen 70 år och äldre var nässpray innehållande ipratropium 1,5 gånger vanligare hos män [16].
Referenser
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Nationella riktlinjer för vård vid astma och kroniskt obstruktiv lungsjukdom (KOL). Socialstyrelsen. [updated 2018-01-29, cited 2020-09-14].
Wedzicha JA, Singh D, Tsiligianni I, Jenkins C, Fucile S, Fogel R et al. Treatment response to indacaterol/glycopyrronium versus salmeterol/fluticasone in exacerbating COPD patients by gender: a post-hoc analysis in the FLAME study. Respir Res. 2019;20(1):4.
Dharmage SC, Perret JL, Custovic A. Epidemiology of Asthma in Children and Adults. Front Pediatr. 2019;7:246.
Dales RE, Mehdizadeh A, Aaron SD, Vandemheen KL, Clinch J. Sex differences in the clinical presentation and management of airflow obstruction. Eur Respir J. 2006;28:319-22.
Tantisira KG, Colvin R, Tonascia J, Strunk RC, Weiss ST, Fuhlbrigge AL et al. Airway responsiveness in mild to moderate childhood asthma: sex influences on the natural history. Am J Respir Crit Care Med. 2008;178:325-31.
Rogliani P, Cavalli F, Ritondo BL, Cazzola M, Calzetta L. Sex differences in adult asthma and COPD therapy: a systematic review. Respir Res. 2022;23(1):222.
Calzetta L, Aiello M, Frizzelli A, Ritondo BL, Pistocchini E, Rogliani P et al. Impact of Sex on Proper Use of Inhaler Devices in Asthma and COPD: A Systematic Review and Meta-Analysis. Pharmaceutics. 2022;14(8):.
Osborne ML, Vollmer WM, Linton KL, Buist AS. Characteristics of patients with asthma within a large HMO: a comparison by age and gender. Am J Respir Crit Care Med. 1998;157:123-8.
Prescott E, Lange P, Vestbo J. Effect of gender on hospital admissions for asthma and prevalence of self-reported asthma: a prospective study based on a sample of the general population Copenhagen City Heart Study Group. Thorax. 1997;52:287-9.
Ng TP, Niti M, Tan WC. Trends and ethnic differences in asthma hospitalization rates in Singapore, 1991 to 1998. Ann Allergy Asthma Immunol. 2003;90:51-5.
Li X, Obeidat M, Zhou G, Leung JM, Tashkin D, Wise R et al. Responsiveness to Ipratropium Bromide in Male and Female Patients with Mild to Moderate Chronic Obstructive Pulmonary Disease. EBioMedicine. 2017;19:139-145.
Chhabra SK, Pandey KK. Comparison of acute bronchodilator effects of inhaled ipratropium bromide and salbutamol in bronchial asthma. J Asthma. 2002;39:375-81.
Partridge MR, Saunders KB. Site of action of ipratropium bromide and clinical and physiological determinants of response in patients with asthma. Thorax. 1981;36:530-3.
Afonso AS, Verhamme KM, Stricker BH, Sturkenboom MC, Brusselle GG. Inhaled anticholinergic drugs and risk of acute urinary retention. BJU Int. 2011;107:1265-72.
Cole JM, Sheehan AH, Jordan JK. Concomitant use of ipratropium and tiotropium in chronic obstructive pulmonary disease. Ann Pharmacother. 2012;46:1717-21.
Statistikdatabas för läkemedel. Stockholm: Socialstyrelsen. 2023 [cited 2024-03-06.]
- Nationella riktlinjer för vård vid astma och kroniskt obstruktiv lungsjukdom (KOL). Socialstyrelsen. [updated 2018-01-29, cited 2020-09-14].
- Wedzicha JA, Singh D, Tsiligianni I, Jenkins C, Fucile S, Fogel R et al. Treatment response to indacaterol/glycopyrronium versus salmeterol/fluticasone in exacerbating COPD patients by gender: a post-hoc analysis in the FLAME study. Respir Res. 2019;20(1):4.
- Dharmage SC, Perret JL, Custovic A. Epidemiology of Asthma in Children and Adults. Front Pediatr. 2019;7:246.
- Dales RE, Mehdizadeh A, Aaron SD, Vandemheen KL, Clinch J. Sex differences in the clinical presentation and management of airflow obstruction. Eur Respir J. 2006;28:319-22.
- Tantisira KG, Colvin R, Tonascia J, Strunk RC, Weiss ST, Fuhlbrigge AL et al. Airway responsiveness in mild to moderate childhood asthma: sex influences on the natural history. Am J Respir Crit Care Med. 2008;178:325-31.
- Rogliani P, Cavalli F, Ritondo BL, Cazzola M, Calzetta L. Sex differences in adult asthma and COPD therapy: a systematic review. Respir Res. 2022;23(1):222.
- Calzetta L, Aiello M, Frizzelli A, Ritondo BL, Pistocchini E, Rogliani P et al. Impact of Sex on Proper Use of Inhaler Devices in Asthma and COPD: A Systematic Review and Meta-Analysis. Pharmaceutics. 2022;14(8):.
- Osborne ML, Vollmer WM, Linton KL, Buist AS. Characteristics of patients with asthma within a large HMO: a comparison by age and gender. Am J Respir Crit Care Med. 1998;157:123-8.
- Prescott E, Lange P, Vestbo J. Effect of gender on hospital admissions for asthma and prevalence of self-reported asthma: a prospective study based on a sample of the general population Copenhagen City Heart Study Group. Thorax. 1997;52:287-9.
- Ng TP, Niti M, Tan WC. Trends and ethnic differences in asthma hospitalization rates in Singapore, 1991 to 1998. Ann Allergy Asthma Immunol. 2003;90:51-5.
- Li X, Obeidat M, Zhou G, Leung JM, Tashkin D, Wise R et al. Responsiveness to Ipratropium Bromide in Male and Female Patients with Mild to Moderate Chronic Obstructive Pulmonary Disease. EBioMedicine. 2017;19:139-145.
- Chhabra SK, Pandey KK. Comparison of acute bronchodilator effects of inhaled ipratropium bromide and salbutamol in bronchial asthma. J Asthma. 2002;39:375-81.
- Partridge MR, Saunders KB. Site of action of ipratropium bromide and clinical and physiological determinants of response in patients with asthma. Thorax. 1981;36:530-3.
- Afonso AS, Verhamme KM, Stricker BH, Sturkenboom MC, Brusselle GG. Inhaled anticholinergic drugs and risk of acute urinary retention. BJU Int. 2011;107:1265-72.
- Cole JM, Sheehan AH, Jordan JK. Concomitant use of ipratropium and tiotropium in chronic obstructive pulmonary disease. Ann Pharmacother. 2012;46:1717-21.
- Statistikdatabas för läkemedel. Stockholm: Socialstyrelsen. 2023 [cited 2024-03-06.]
Uppdaterat
Litteratursökningsdatum: 10/17/2024
Litteratursökningsdatum: 10/17/2024Se även
Tiotropium