Combination bronchodilator therapy in the management of chronic obstructive pulmonary disease

Respiratory Research

Table 2 LABAs and LAMAs in development for combination therapies

Therapy	LABA/LAMA	Manufacturer	Dosage	Time to onset	Trough FEV₁(difference from placebo)
Formoterol	LABA	Merck^a	Twice daily	5 min [26]	50–90 mL [26]
Formoterol	LABA	Merck^a	4.5 μg (MDI) and 12 μg (DPI)	5 min [26]	50–90 mL [26]
Indacaterol	LABA	Novartis	Once daily 150 and 300 μg (EU) (DPI) [20]	5 min [22]	130–180 mL (p < 0.001) [22]
Indacaterol	LABA	Novartis	Once daily 75 μg (US) (DPI) [21]	5 min [22]	≥120 mL (p < 0.001) [23, 33]
Olodaterol	LABA	Boehringer Ingelheim	Once daily 5 and 10 μg (Respimat®)	Not available	61–132 mL (p < 0.01) [24]
Vilanterol	LABA	GSK	Once daily 25 and 50 μg (DPI)	Median 6 min [25]	137–165 mL (p < 0.001) [25]
Aclidinium	LAMA	Almirall/Forest Laboratories	Twice daily 200–400 μg (DPI)	10–30 min [27, 28]	86–124 mL (p < 0.0001) [29]
Glycopyrronium	LAMA	Novartis	Once daily 50 μg (DPI)	5 min [19, 34]	91–108 mL (p < 0.001) [30, 34]
Glycopyrrolate	LAMA	Pearl Therapeutics	Twice daily 36 μg (MDI)	5 min [19]	Statistically superior to placebo (p < 0.0001) [31]
GSK233705	LAMA	GSK	Twice daily 200 μg	Not available	130 mL (p < 0.001) [32]
Tiotropium	LAMA	Boehringer Ingelheim	Once daily 18 μg (DPI) and 5 μg (via SMI)	15 min [18]	120–150 mL (p < 0.001) [18]
Umeclidinium (GSK573719)	LAMA	GSK	Once daily	Not available	Not available

^aOther companies are developing formoterol as part of a fixed-dose combination.
PubMed and European Respiratory Society and American Thoracic Society congresses were searched for abstracts relating to LAMA/LABA therapies known to be in development as part of a combination. As trials were carried out in different patient populations and there were differences in background medications allowed/utilized, no direct comparisons can be made.
DPI = dry powder inhaler; LABA = long-acting β₂-agonist; LAMA = long-acting muscarinic antagonist; MDI = metered dose inhaler; SMI = Soft Mist™ Inhaler.

ISSN: 1465-993X