An important step in simplifying
asthma and
chronic obstructive pulmonary disease (
COPD) management and improving adherence with prescribed
therapy is to reduce the dose frequency to the minimum necessary to maintain disease control. Therefore, the incorporation of once-daily dose administration is an important strategy to improve adherence and is a regimen preferred by most patients, which may also lead to enhancement of compliance, and may have advantages leading to improved overall clinical outcomes. Once-daily beta2-agonists or ultra long-acting beta2-agonists (LABAs) such as
carmoterol,
indacaterol, GSK-159797, GSK-597901, GSK-159802, GSK-642444 and GSK-678007 are under development for the treatment of
asthma and
COPD. Also some new long-acting
antimuscarinic agents (LAMAs) such as aclidinium, LAS-35201, GSK656398, GSK233705,
NVA-237 (
glycopyrrolate) and OrM3 are under development. In any case, the current opinion is that it will be advantageous to develop
inhalers containing combination of several classes of long-acting
bronchodilator drugs in an attempt to simplify treatment regimens as much as possible. Consequently, several options for once-daily dual-action ultra LABA+LAMA combination products are currently being evaluated. A different approach is to have a dimer molecule in which both pharmacologies are present (these molecules are known as M3 antagonist-beta2 agonist (MABA)
bronchodilators). The advent of a successful MABA product will revolutionize the field and open the door for a new range of combination products.