A role of fixed combinations of long-acting anticholinergics and long-acting #b2-agonists in therapy of chronic obstructive pulmonary disease

Abstract

Treatment with fixed combinations of a long-acting anticholinergic (LAMA) glycopyrronium and a long-acting #b₂-agonist (LABA) indacaterol is characterized by high clinical efficacy when compared to single components. Published results of clinical trials are in line with the pharmacological theory about synergy of bronchodilators with different mechanisms of action such as LAMA and LABA. Importantly, an additional therapeutic effect could be achieved without increasing risk of adverse events. This allows conclusion that administration of indacaterol and glycopyrronium could achieve the optimal and maximal bronchodilation in most patients with chronic obstructive pulmonary disease (COPD) who fail to improve bronchial obstruction with a single bronchodilator. A combined therapy with indacaterol and glycopyrronium (QVA149) was shown to significantly improve clinical symptoms, lung function, quality of life and decrease in number of exacerbations in COPD patients.