Glycopyrrolate and formoterol fumarate for the treatment of COPD

ABSTRACT

Introduction

Long acting bronchodilators are nowadays the central treatment for management of stable COPD. Several combinations exist within the market with different formulation devices. This article reviews a recent dual combination of glycopyrronium and formoterol fumarate in an innovative pMDI-fixed dual combination, Bevespi® Aerosphere.

Areas covered

This article explored the literature to understand the place of this novel combination and unique delivery drug device in today’s therapeutic arsenal. Clinical efficacy and safety have been evaluated through the different clinical trials published in public databases.

Expert opinion

Within the fixed-dose combinations, Glycopyrrolate and formoterol fumarate offer a credible unique pMDI option to be given twice a day. LABA-LAMA offers an ICS-free alternative in COPD pharmacology which represents an important treatment option given the current debate over whether or not, maintenance triple therapy combined with ICS are benefic in the long term.

KEYWORDS:

• Bronchodilators
• COPD
• pMDI

Article highlights

• Glycopyrronium and formoterol fumarate (GFF) is the only LAMA/LABA fixed combination formulated as a metered dose inhaler (MDI) delivered through an Aerosphere inhaler available.

• GFF improves lung function through forced expiratory volume in 1 s (FEV₁) and inspiratory capacity (IC) better than placebo and mono-components taken individually.

• GFF reduces the use of rescue medication, improves dyspnea and the quality of life.

• GFF is as safe as its comparators.

• The association of GFF to ICS needs to be discussed as new combination of GFF and ICS have been tested in phase III and approved in COPD maintenance therapy.

Acknowledgments

The Uppsala Monitoring Centre has provided the data but the study results and conclusions are those of the authors and not necessarily those of the Uppsala Monitoring Centre, National Centers, or WHO.

Declaration of interest

A Bourdin reports grants from AstraZeneca, during the conduct of the study; grants, personal fees, non-financial support and other from AstraZeneca, grants, personal fees, non-financial support and other from Boeringher Ingelheim, grants, personal fees, non-financial support and other from GlaxoSmithKline, personal fees, non-financial support and other from Novartis, personal fees and non-financial support from Teva, personal fees, non-financial support and other from Regeneron, personal fees, non-financial support, and other from Chiesi Farmaceuticals, grants, personal fees, non-financial support and other from Actelion, personal fees from Gilead, non-financial support and other from Roche, other from Nuvaira, from null, outside the submitted work. 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 apart from those disclosed.

Reviewer disclosures

A reviewer on this manuscript has disclosed that they have provided lectures or other expert work to the manufacturers of all LAMA-LABA-combinations e.g. AstraZeneca, GlaxoSmithKline, Boehringer-Ingelheim, Novartis. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Scientific accuracy review

AstraZeneca provided a scientific accuracy review at the request of the journal editor

Additional information

Funding

This paper was not funded.