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Profile of inhaled glycopyrronium bromide as monotherapy and in fixed-dose combination with indacaterol maleate for the treatment of COPD

Authors Prakash A, Babu KS, Morjaria JB

Received 14 May 2014

Accepted for publication 7 August 2014

Published 7 January 2015 Volume 2015:10(1) Pages 111—123

DOI https://doi.org/10.2147/COPD.S67758

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Dr Richard Russell

Anoop Prakash,1 K Suresh Babu,2 Jaymin B Morjaria1,3

1Department of Respiratory Medicine, Castle Hill Hospital, Cottingham, 2Department of Respiratory Medicine, Queen Alexandra Hospital, Cosham, Portsmouth, 3Department of Academic Respiratory Medicine, Hull York Medical School, University of Hull, Castle Hill Hospital, Cottingham, UK

Abstract: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. The cornerstone of pharmacological treatment for COPD is bronchodilation. Inhaled glycopyrronium bromide is a long-acting muscarinic antagonist developed as a maintenance treatment for patients with COPD. Phase III trials have shown that glycopyrronium produces rapid and sustained bronchodilation with an efficacy similar to tiotropium and is well tolerated, with a low incidence of muscarinic side effects in patients with moderate to severe COPD. A combination of glycopyrronium bromide with indacaterol maleate (QVA149) has recently been approved as a once-daily maintenance therapy in adult patients with COPD. Phase III trials (the IGNITE program) with QVA149 have demonstrated significant improvements in lung function versus placebo, glycopyrronium, and tiotropium in patients with moderate to severe COPD, with no safety concerns of note. Hence QVA149 is a safe treatment option for moderate to severe COPD patients in whom long-acting muscarinic antagonist monotherapy is inadequate.

Keywords: chronic obstructive pulmonary disease, glycopyrronium bromide, indacaterol maleate, umeclidinium, QVA149, long-acting muscarinic antagonist

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