Safety of inhaled long-acting anti-muscarinic agents in COPD

ABSTRACT

Evidence-based guidelines recommend inhaled long-acting anti-muscarinic agents (LAMAs) as first-line maintenance therapy for symptomatic patients with COPD. Several LAMAs are now available for use either as monotherapy or in combination with other COPD medications, including long-acting β₂-agonists (LABAs) or inhaled corticosteroids (ICS). The efficacy and long-term safety of these medications have been evaluated in multiple clinical trials and real-life studies. This review evaluates the evidence available on the safety of existing LAMAs alone or in combination with LABAs and ICS in patients with COPD.

KEYWORDS:

• Chronic obstructive pulmonary disease (COPD)
• safety
• long-acting anti-muscarinics (LAMA)
• tiotropium
• aclidinium
• glycopyrronium
• umeclidinium

Declaration of Interest

Writing, editorial support, and formatting assistance were provided by Priyanka Narang, PhD and Gill Sperrin, CBiol, MRSB, CMPP of Envision Scientific Solutions, which was contracted and compensated by Boehringer Ingelheim Pharmaceuticals, Inc. (BIPI) for these services. BIPI was given the opportunity to review the manuscript for medical and scientific accuracy as well as intellectual property considerations. NA Hanania has received honoraria for serving as an advisor or as a consultant for Boehringer Ingelheim, Sunovion, Novartis, Genentech, and Pfizer; his institution has received research support on his behalf from GlaxoSmithKline, Boehringer Ingelheim, Sunovion, Mylan, Pearl, Novartis, Pfizer, and Genentech. SC Lareau is on the Medical Advisory Board of Boehringer Ingelheim. BP Yawn has received grants from Boehringer Ingelheim, is on the COPD Advisory Boards of Boehringer Ingelheim, Novartis, and AstraZeneca, and supports training of speaker faculty at Boehringer Ingelheim. 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.

Additional information

Funding

This work was supported by Boehringer Ingelheim Pharmaceuticals, Inc. (BIPI).