medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-182medsovet-10247Research ArticleХРОНИЧЕСКИЕ ЗАБОЛЕВАНИЯ ЛЕГКИХCHRONIC PULMONARY DISEASESТиотропия бромид: продолжение пути бронхолитика длительного действия в современной реальной клинической практикеTiotropium bromide: Continuing the path of a long-acting bronchodilator in contemporary real-world clinical practicehttps://orcid.org/0000-0001-5028-5276ВизельА. А.VizelA. A.

Визель Александр Андреевич - д.м.н., профессор, заведующий кафедрой фтизиопульмонологии.

420012, Казань, ул. Бутлерова, д. 49; SPIN-код: 5918-5465; Scopus Author ID: 195447

Aleksandr A. Vizel - Dr. Sci. (Med.), Professor, Head of the Department of Phthisiopulmonology.

49, Butlerov St., Kazan, 420012, Scopus Author ID: 195447

lordara@inbox.ruhttps://orcid.org/0000-0002-8855-8177ВизельИ. Ю.VizelI. Yu.

Визель Ирина Юрьевна - д.м.н., доцент, профессор кафедры фтизиопульмонологии.

420012, Казань, ул. Бутлерова, д. 49; SPIN-код: 6000-3813; Scopus Author ID: 246946

Irina Yu. Vizel - Dr. Sci. (Med.), Associate Professor, Professor of the Department of Phthisiopulmonology.

49, Butlerov St., Kazan, 420012, Russia; Scopus Author ID: 246946

tatpulmo@mail.ruКазанский государственный медицинский университетРоссияKazan State Medical UniversityRussian Federation202614072026092835Copyright © Визель А.А., Визель И.Ю., 20262026Визель А.А., Визель И.Ю.Vizel A.A., Vizel I.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/10247

Ингаляционная бронхолитическая терапия остается неотъемлемой частью лечения больных ХОБЛ и бронхиальной астмой. Представлен аналитический обзор отечественной и зарубежной литературы последних трех лет, посвященный первому в истории селективному антихолинергическому ингаляционному бронхолитику длительного действия тиотропия бромиду (ТБ). Был проведен поиск в электронных библиотеках PubMed и eLIBRARY.RU по ключевому слову «тиотропия бромид» и просмотрено 213 статей. Для анализа было отобрано 40 статей, которые содержали результаты клинических исследований ТБ – рандомизированных, сравнительных и наблюдательных. Значительная часть статей была исключена из-за повтора описаний одних и тех же исследований. Представлены работы, в которых продолжается изучение ТБ, доказаны надежность бронхолитического действия и высокая степень безопасности. Описаны внелегочные эффекты ТБ. Особое внимание уделено жидкостным лекарственным формам, проблемам техники ингаляций и приверженности лечению. Несмотря на то что препарат применяется более 20 лет, изучение его свойств в России и за рубежом продолжается, создаются комбинации с ним, совершенствуются формы доставки. Наличие надежного холиноблокирующего средства длительного действия в качестве монотерапии, а также компонента двойного ингаляционного бронхолитика или второго бронхолитика в тройной ингаляционной композиции повышает вероятность достижения контроля над обструкцией как при ХОБЛ, так и при бронхиальной астме, позволяет снизить стероидную нагрузку или предотвратить ранний переход на биологическую терапию. Появление дозирующего аэрозольного ингалятора с ТБ стало новым шагом к его применению в России. Целесообразность применения ТБ при хронических бронхообструктивных заболеваниях в виде новой лекарственной формы дозирующего аэрозольного ингалятора обусловлена проблемой приверженности к лечению, предпочтениями пациентов при выборе средства доставки, способностью правильно пользоваться ингаляторами. Выход новой лекарственной формы в реальную клиническую практику в России был рекомендован на совещании федеральных пульмонологов специалистов-экспертов в 2025 г.

Inhaled bronchodilator therapy remains an integral part of treatment for patients with COPD and bronchial asthma. This article presents an analytical review of Russian and international literature from the past three years devoted to the first-ever selective, long-acting anticholinergic inhaled bronchodilator, tiotropium bromide (TB). A search of PubMed and eLIBRARY.RU using the keyword “tiotropium bromide” was conducted, and 213 articles were reviewed. Forty articles containing the results of clinical trials of TB – randomized, comparative, and observational – were selected for analysis. A significant number of articles were excluded due to duplicate descriptions of the same studies. This article presents studies that continue to study TB and have demonstrated the reliability of its bronchodilator effect and a high degree of safety. The extrapulmonary effects of TB are described. Particular attention is paid to liquid dosage forms, inhalation technique issues, and treatment adherence. Despite the drug’s use for over 20 years, its properties continue to be studied in Russia and abroad, with combinations being developed and delivery methods being improved. The availability of a reliable, long-acting anticholinergic agent as mono-therapy, as well as a dual inhaled bronchodilator component or a second bronchodilator in a triple inhalation formulation, increases the likelihood of achieving obstruction control in both COPD and asthma, allowing for a reduction in steroid use or an early transition to biological therapy. The introduction of a metered-dose aerosol inhaler with TB marks a new step toward its use in Russia. The feasibility of using TB for chronic broncho-obstructive diseases as a new metered-dose aerosol inhaler is driven by issues of treatment adherence, patient preferences in choosing a delivery method, and the ability to use inhalers correctly. The introduction of this new dosage form into clinical practice in Russia was recommended at a meeting of federal pulmonology experts in 2025.

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The authors declare that there are no conflicts of interest present.