Umeclidinium/Vilanterol and Umeclidinium in COPD
Umeclidinium/Vilanterol and Umeclidinium in COPD
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable condition characterized by persistent airflow obstruction that is not fully reversible. The pharmacological management of stable COPD primarily aims to improve symptoms and quality of life, optimize lung function, reduce COPD exacerbations, and improve exercise tolerance. Bronchodilators are central to the pharmacological management of COPD, and include long-acting muscarinic antagonists (LAMAs) and long-acting β2-adrenergic agonists (LABAs). Muscarinic antagonists bind to M3 receptors, thereby blocking the bronchoconstrictive response to cholinergic nervous stimulation, while β2-agonists stimulate β2-adrenergic receptors and increase levels of cyclic adenosine monophosphate. Both mechanisms facilitate airway smooth muscle relaxation.
The combination of these distinct and complementary mechanisms of action may provide the opportunity for improved treatment efficacy. Indeed, the co-administration of LAMAs and LABAs has been shown to produce significantly greater improvements in lung function compared with the monotherapy components in patients with COPD, as have their short-acting counterparts. In addition to stabilizing lung function over 24 hours, the development of a LAMA/LABA combination treatment may also improve treatment adherence due to the convenience of a once-daily treatment regimen, and administration of both drugs via a single inhaler. A LAMA/LABA therapy may also be associated with a lower risk of side effects in comparison with increasing the dose of a single agent.
The LAMA umeclidinium (UMEC) and the combination of UMEC with the LABA vilanterol (UMEC/VI) are approved maintenance treatments for COPD in the US and EU. They are not indicated for the treatment of asthma. Previous studies have shown that both UMEC and VI can significantly improve lung function over 24 hours. Studies have also demonstrated that UMEC and VI are well tolerated over a 6-month period, but data on longer-term exposure are lacking at present. This study was conducted to examine the safety and tolerability of once-daily UMEC/VI 125/25 mcg and UMEC 125 mcg compared with placebo over 12 months in patients with COPD.
Background
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable condition characterized by persistent airflow obstruction that is not fully reversible. The pharmacological management of stable COPD primarily aims to improve symptoms and quality of life, optimize lung function, reduce COPD exacerbations, and improve exercise tolerance. Bronchodilators are central to the pharmacological management of COPD, and include long-acting muscarinic antagonists (LAMAs) and long-acting β2-adrenergic agonists (LABAs). Muscarinic antagonists bind to M3 receptors, thereby blocking the bronchoconstrictive response to cholinergic nervous stimulation, while β2-agonists stimulate β2-adrenergic receptors and increase levels of cyclic adenosine monophosphate. Both mechanisms facilitate airway smooth muscle relaxation.
The combination of these distinct and complementary mechanisms of action may provide the opportunity for improved treatment efficacy. Indeed, the co-administration of LAMAs and LABAs has been shown to produce significantly greater improvements in lung function compared with the monotherapy components in patients with COPD, as have their short-acting counterparts. In addition to stabilizing lung function over 24 hours, the development of a LAMA/LABA combination treatment may also improve treatment adherence due to the convenience of a once-daily treatment regimen, and administration of both drugs via a single inhaler. A LAMA/LABA therapy may also be associated with a lower risk of side effects in comparison with increasing the dose of a single agent.
The LAMA umeclidinium (UMEC) and the combination of UMEC with the LABA vilanterol (UMEC/VI) are approved maintenance treatments for COPD in the US and EU. They are not indicated for the treatment of asthma. Previous studies have shown that both UMEC and VI can significantly improve lung function over 24 hours. Studies have also demonstrated that UMEC and VI are well tolerated over a 6-month period, but data on longer-term exposure are lacking at present. This study was conducted to examine the safety and tolerability of once-daily UMEC/VI 125/25 mcg and UMEC 125 mcg compared with placebo over 12 months in patients with COPD.