Evaluating revefenacin as a therapeutic option for chronic obstructive pulmonary disease

ABSTRACT

Introduction

In chronic obstructive pulmonary disease (COPD), inhaled long-acting antimuscarinic agents (LAMA) are effective maintenance therapies used across all severity stages of the disease. Most of them are administered via dry powder inhalers, but these devices require a potent inspiratory flow which cannot be effectively achieved by patients with advanced disease. In such patients, inhaled therapy via nebulization might be an option.

Areas covered

Revefenacin is a LAMA that was specifically formulated for once daily nebulization and which was authorized by the FDA as a maintenance therapy for COPD. In phase II and III clinical studies discussed in this review, revefenacin demonstrated its rapid onset of action and sustained effect on lung function on both a short- and long-term basis.

Expert opinion

Nebulized revefenacin with once daily use does not require any particular effort of administration and hence can be used by patients with severe airways obstruction or by those having milder cognitive deficits. Further studies are needed, however, to better document the long-term cardiovascular safety and its ability to reduce the exacerbation rate.

KEYWORDS:

• Chronic obstructive pulmonary disease
• inhaled therapies
• long-acting antimuscarinic
• nebulization
• revefenacin
• tiotropium

Declaration of interest

S Antoniu has received congress fees from Chiesi Farmaceutici and Angelini. R Rajnoveanu, R Ulmeanu and F Mihaltan have all received congress and speaker’s fees from GlaxoSmithKline, Boehringer Ingelheim, Pfizer Inc and AstraZeneca. 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

One referee has participated in consulting, advisory boards, speaker panels, or received travel reimbursement from Amphastar, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, Cipla, GlaxoSmithKline, Mylan, Novartis, Oriel, Pearl, Sunovion, Teva and Theravance. They have also conducted multicenter clinical research trials for approximately 40 pharmaceutical companies. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This manuscript was not funded.