This systematic review explored the efficacy and safety of
aclidinium bromide in comparison with placebo and other long-acting
bronchodilators for treatment of moderate to severe
COPD. Randomised controlled trials were identified through systematic searches of different databases of published trials.
RESULTS: Ten trials (3.922 participants) were included.
Aclidinium bromide appears to be a safe and well-tolerated long-acting
anti-cholinergic bronchodilator with a relatively fast onset of action. Compared with other long-acting
bronchodilators, including
tiotropium bromide,
aclidinium bromide leads to at least similar clinically important improvements in level of FEV(1), health status, use of rescue medication, and day-time
dyspnea scores in patients suffering from moderate to severe
COPD. With twice-daily dosing,
aclidinium bromide may have clinically important effect on night-time symptom scores in
COPD patients, but further studies are needed in order to permit valid conclusions with regard to this point. The effect of
aclidinium bromide on exercise tolerance, as assessed by exercise endurance time, and dynamic hyperinflation in patients with moderate to severe
COPD seems to be at least comparable to other long-acting
bronchodilators, incl.
tiotropium bromide and
indacaterol.
Aclidinium bromide might reduce the rate of exacerbations in
COPD patients, but conclusions must await further long-term controlled trials.
CONCLUSION:
Aclidinium bromide has effects on relevant
COPD outcome measures, including level of FEV(1), similar to other long-acting
bronchodilators, and therefore seems to have the potential for a significant role in the future management of moderate to severe
COPD.