New developments in optimizing bronchodilator treatment of COPD: a focus on glycopyrrolate/formoterol combination formulated by co-suspension delivery technology.

COPD causes considerable health and economic burden worldwide, with incidence of the disease expected to continue to rise. Inhaled bronchodilators, such as long-acting muscarinic antagonists (LAMAs) and long-acting β ₂ -agonists (LABAs), are central to the maintenance treatment of patients with COPD. Clinical studies have demonstrated that combined LAMA + LABA therapies improve efficacy while retaining a safety profile similar to LAMA or LABA alone. This has led to the development of several LAMA/LABA fixed-dose combination (FDC) therapies, which provide patients with the convenience of two active compounds in a single inhaler. GFF MDI (Bevespi Aerosphere ^® ) is an FDC of glycopyrrolate/formoterol fumarate 18/9.6 µg formulated using innovative co-suspension delivery technology for administration via metered dose inhaler (MDI). GFF MDI was developed to make a treatment option available for patients who have a requirement or preference to use an MDI, rather than a dry powder or soft mist inhaler. Now that several LAMA/LABA FDCs have been approved for use in COPD, we review the impact of dual-bronchodilator treatment on COPD therapy and discuss recent clinical studies that are helping to develop a more comprehensive understanding of how LAMA/LABA FDCs can improve patient outcomes.
Competing Interests: Disclosure ADD has received research, consulting, and lecturing fees from Almirall, Altana, AstraZeneca, Boehringer Ingelheim (Canada), Forest Laboratories, GlaxoSmithKline, KOS Pharmaceuticals, Merck Canada, Methapharm, Novartis Canada/USA, Ono Pharmaceutical, Pfizer Canada, Schering-Plow, Sepracor, and Skyepharma. MC has participated as a speaker and/or advisor in scientific meetings and courses under the sponsorship of Almirall, AstraZeneca, Biofutura, Boehringer Ingelheim, Chiesi Farmaceutici, GlaxoSmithKline, Lallemand, Menarini Group, Mundipharma, Novartis, Pfizer, Verona Pharma, and Zambon, and is or has been a consultant to ABC Farmaceutici, Chiesi Farmaceutici, Lallemand, Novartis, Recipharm, Teva, Verona Pharma, and Zambon. His institution has received grants on his behalf from Almirall, Boehringer Ingelheim, Novartis, Verona Pharma, and Zambon. NAH has participated in scientific advisory boards and consulted for AstraZeneca, Genentech, GlaxoSmithKline, Mylan, Novartis, Roche, Sunovion, and Sanofi. His institution has received grants on his behalf from AstraZeneca, Boehringer Ingelheim, Chiesi, Genentech, GlaxoSmithKline, Mylan, and Sunovion. RB reports personal fees from Astra-Zeneca, Chiesi, GlaxoSmithKline, and Takeda, and grants and personal fees from Boehringer Ingelheim, Novartis, and Roche. MRMY has received research funding, consulting fees, and speaker honoraria from Almirall, AstraZeneca, Boehringer Ingelheim, Forest Laboratories, GlaxoSmith-Kline, Novartis, Merck, Ono Pharmaceuticals, and Pfizer. The authors report no other conflicts of interest in this work.