Role of dual bronchodilators in COPD: A review of the current evidence for indacaterol/glycopyrronium.

Abstract

In this review, we summarize the rationale for combining long-acting bronchodilators in the management of chronic obstructive pulmonary disease (COPD), and the evidence for the long-acting bronchodilator combination indacaterol/glycopyrronium (IND/GLY). Clinical practice guidelines generally recommend the use of long-acting bronchodilators in the treatment of patients with all severities of COPD, either as a first-choice or alternative-choice therapy. Combining classes of long-acting bronchodilators can result in superior improvements in lung function and clinical outcomes compared with bronchodilator monotherapy, as observed in studies of free combinations of long-acting β2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs). LABA/LAMA fixed-dose combinations (FDCs) can also significantly improve lung function, dyspnea, symptoms and health status and reduce exacerbations and rescue medication use versus an inhaled corticosteroid/LABA, with a comparable safety profile and lower incidence of pneumonia. The LABA/LAMA FDC of IND/GLY is approved for use in the management of COPD. This review summarizes the evidence for IND/GLY, including its pharmacodynamic and pharmacokinetic profile, and published efficacy and safety data from clinical trials in patients with COPD. We also explore the unmet needs in COPD and discuss the potential future of COPD management.

• Authors: Joachim H Ficker, Klaus F Rabe, Tobias Welte
• Journal: Pulmonary pharmacology & therapeutics (Pulm Pharmacol Ther) Vol. 45 Pg. 19-33 (08 2017) ISSN: 1522-9629 [Electronic] England
• PMID: 28389258 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Chemical References

• Adrenergic beta-2 Receptor Agonists
• Bronchodilator Agents
• Drug Combinations
• Glucocorticoids
• Indans
• Muscarinic Antagonists
• Quinolones
• indacaterol-glycopyrronium combination
• Glycopyrrolate

Topics

• Administration, Inhalation
• Adrenergic beta-2 Receptor Agonists (administration & dosage, adverse effects)
• Animals
• Bronchodilator Agents (administration & dosage, adverse effects, pharmacology)
• Drug Combinations
• Glucocorticoids (administration & dosage, adverse effects)
• Glycopyrrolate (administration & dosage, adverse effects, pharmacology)
• Humans
• Indans (administration & dosage, adverse effects, pharmacology)
• Muscarinic Antagonists (administration & dosage, adverse effects, pharmacology)
• Pulmonary Disease, Chronic Obstructive (drug therapy, physiopathology)
• Quinolones (administration & dosage, adverse effects, pharmacology)
• Severity of Illness Index