Aclidinium bromide and formoterol fumarate for the maintenance treatment of chronic obstructive pulmonary disease

ABSTRACT

Introduction: Treatment options for COPD have evolved rapidly in the last decade and inhaled bronchodilators have largely supplanted the use of oral bronchodilators because of their increased efficacy and excellent safety with topical delivery to the lung. Recently added to the therapeutic armamentarium are fixed-dose combinations (FDC) of two long acting bronchodilators. LAMAs (long acting muscarinic antagonists) and LABAs (long acting beta agonists) are the main classes available and use different pathways to effectively produce bronchial smooth muscle relaxation.

Areas covered: The most recent inhaled FDC LAMA/LABA to come to market is Aclidinium Bromide and Formoterol Fumarate. We searched databases of PubMed, Cochrane Library, and manufacturers’ websites and retrieved all the randomized-controlled trials (RCTs) conducted with these drugs up to September 2019.

Expert opinion: It is likely that FDCs will become the core of our COPD pharmacotherapy for all but the mildest COPD patients. These individual drugs have excellent efficacy and safety records for the maintenance treatment of COPD. Studies have demonstrated that twice daily treatment with aclidinium/formoterol resulted in significant improvement in lung function and an improved exercise tolerance when compared to placebo. Adverse effects are within the range of what is seen with other LAMA/LABA combinations.

KEYWORDS:

• Maintenance treatment for COPD
• fixed-Dose Combination (FDC)
• COPD
• aclidinium bromide
• formoterol fumarate
• lama
• laba
• dual bronchodilator therapy
• muscarinic antagonist
• beta agonist

Article Highlights

• Aclidinium bromide/formoterol fumarate has recently been approved by the FDA for maintenance therapy treatment of COPD.

• Multiple studies have shown this dual-therapy inhaled medication to be effective in the maintenance treatment of COPD when compared with placebo and other drugs.

• Multiple studies have shown that regular use lead to decreased COPD symptoms, improved lung function, decreased exacerbations, and increased exercise tolerance.

• Inhaled aclidinium bromide/formoterol fumarate is a safe medication with mild side effects.

• Combined aclidinium bromide/formoterol fumarate is an excellent addition to the arsenal of LAMA/LABA combinations that already exist and will be used as the standard therapy for all but the mildest forms of COPD.

Disclosure Statement

In accordance with Taylor & Francis policy and our ethical obligation as researchers, we are reporting the following potential financial conflicts of interest in the past 12 months.

Ryan Haley: None

Nita Gupta: None

Sanjay Sethi: Research grants (to institution) from Sanofi, GSK, Cipla; Honoraria for advisory boards, consulting or speaking from Astra Zeneca, BI, GSK, Pulmonx, Circassia; Royalties from UptoDate and Merck.