Single inhaler triple therapy with extrafine beclomethasone, formoterol, and glycopyrronium for the treatment of chronic obstructive pulmonary disease.

Abstract

INTRODUCTION:

Chronic obstructive pulmonary disease (COPD) management focuses on the alleviation of symptoms and prevention of exacerbations. Inhaled long acting bronchodilators and inhaled corticosteroids (ICS) are the main classes of treatment for COPD. Triple therapy with a long acting beta2-agonist (LABA), long acting muscarinic antagonist (LAMA), and ICS is commonly prescribed for symptomatic COPD patients experiencing regular exacerbations. Triple therapy is usually administered using separate inhalers; there is little clinical trial evidence of an effect on exacerbation prevention with this approach. Areas covered: This evaluation reviews the single inhaler extrafine combination containing beclometasone diproprionate (BDP), formoterol fumarate (FF), and glycopyrronium bromide (GB) which has been developed as a simplified triple regime. BDP/FF/GB significantly reduced exacerbation rates in three clinical trials (1-year duration) compared against LAMA monotherapy (20% exacerbation reduction), ICS/LABA combination (23% exacerbation reduction), and LAMA/LABA combination (15% exacerbation reduction). Expert opinion: The practical benefits of single inhaler triple therapy in the real world have not been studied. However, the robust clinical trial evidence that BDP/FF/GB reduces exacerbations compared to double combination treatments and LAMA monotherapy cements triple therapy positioning as an escalation step in COPD management pathways.

• Authors: Dave Singh
• Journal: Expert opinion on pharmacotherapy (Expert Opin Pharmacother) Vol. 19 Issue 11 Pg. 1279-1287 (Aug 2018) ISSN: 1744-7666 [Electronic] England
• PMID: 29985096 (Publication Type: Journal Article)

Chemical References

• Adrenergic beta-2 Receptor Agonists
• Beclomethasone
• Glycopyrrolate
• Formoterol Fumarate

Topics

• Administration, Inhalation
• Adrenergic beta-2 Receptor Agonists (pharmacology, therapeutic use)
• Beclomethasone (pharmacology, therapeutic use)
• Drug Therapy, Combination (methods)
• Formoterol Fumarate (pharmacology, therapeutic use)
• Glycopyrrolate (pharmacology, therapeutic use)
• Humans
• Pulmonary Disease, Chronic Obstructive (drug therapy, pathology)