Umeclidinium/vilanterol combination inhaler efficacy and potential impact on current chronic obstructive pulmonary disease management guidelines

Abstract

Introduction: Umeclidinium bromide (UM) with vilanterol (VI) is the first once-daily long-acting muscarinic antagonist/long-acting β2 agonist (LAMA/LABA) combination approved for use in the treatment of chronic obstructive pulmonary disease (COPD) in the USA. Prior to this, only combinations of short-acting bronchodilators and short-acting muscarinic antagonists were available in the USA as a single inhaler and they required frequent dosing. LAMA or LABA therapy is the recommended first choice for moderate-to-very severe COPD with combination therapy added if monotherapy fails to control patients’ symptoms. This allows lower dosing of individual medications, which may limit adverse effects. It could also have the additional benefit of improving patient compliance by making medication regimens less laboring.

Areas covered: A comprehensive literature search of journal articles and abstracts looking for trials that evaluated both the efficacy and the safety of UM/VI revealed that UM/VI improves patients’ lung function and overall health status, while maintaining excellent safety and tolerability profiles compared to placebo and other bronchodilators.

Expert opinion: Given the clinical efficacy, favorable safety profile and ease of use, clinicians may recommend UM/VI to patients with moderate-to-very severe COPD – a shift that could have significant impact on the management of COPD.

Keywords:

• bronchodilator
• chronic obstructive pulmonary disease
• forced expiratory volume in 1 s
• forced vital capacity
• long-acting β agonists
• long-acting muscarinic antagonist
• umeclidinium
• vilanterol

Declaration of interest

JA Ohar received editorial assistance from Glaxo SmithKline for a manuscript published within the past year and consultancy fees from Astra Zeneca and CSL Behring. JF Donohue is a consultant and advisor to Sunovian. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents, received or pending, or royalties.