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Profile of glycopyrronium for once-daily treatment of moderate-to-severe COPD
Received 16 July 2012
Accepted for publication 3 September 2012
Published 26 October 2012 Volume 2012:7 Pages 729—741
DOI https://doi.org/10.2147/COPD.S36001
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 5
Roland Buhl,1 Donald Banerji2
1Pulmonary Department, Mainz University Hospital, Mainz, Germany; 2Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
Abstract: Bronchodilators are central in the symptomatic management of chronic obstructive pulmonary disease (COPD). Long-acting muscarinic antagonists (LAMAs) and long-acting β2-agonists (LABAs) are the main classes of long-acting bronchodilators. To date, tiotropium is the only once-daily LAMA available for the treatment of COPD. Glycopyrronium is a novel LAMA, currently in development for COPD. Phase II studies have shown that glycopyrronium 50 µg once daily provides clinically significant 24-hour bronchodilation with a rapid onset of action, which is faster than that of tiotropium, and a favorable safety and tolerability profile. The Phase III GLycopyrronium bromide in COPD airWays (GLOW) program has now confirmed the long-term efficacy and tolerability of glycopyrronium 50 µg once daily. The three studies included in this program have further shown that the effect of glycopyrronium versus placebo is similar to that of tiotropium in reducing dyspnea and the risk of exacerbations, as well as improving lung function, exercise tolerance, and health status in patients with COPD. The safety profile of glycopyrronium is also similar to that of tiotropium in terms of overall incidence of adverse events and muscarinic side effects. Glycopyrronium could be an alternative choice to tiotropium, and like tiotropium, has the potential to be used as a monotherapy or combination therapy. Phase II studies have shown that a fixed-dose combination of glycopyrronium and the 24-hour LABA indacaterol, produces rapid and sustained bronchodilation compared with indacaterol monotherapy in patients with COPD. Phase III studies are currently ongoing to assess the long-term efficacy and safety of this combination.
Keywords: NVA237, glycopyrronium, chronic obstructive pulmonary disease, once daily, muscarinic antagonist
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