Aclidinium bromide for the treatment of chronic obstructive pulmonary disease.

Inhaled aclidinium bromide has recently been approved by the European Medicines Agency and the U.S. Food and Drug Administration for the maintenance bronchodilator treatment to relieve symptoms of patients with chronic obstructive pulmonary disease (COPD). Aclidinium bromide is a competitive muscarinic receptor antagonist with kinetic selectivity for the muscarinic M(3) receptor and with a long duration of action. It is rapidly hydrolyzed in human plasma, and its metabolites have no activity on muscarinic receptors. Initial phase I and II studies in patients with COPD indicated that aclidinium bromide 200 μg o.d. had a bronchodilator activity up to 24 hours. However, in subsequent phase III studies, the bronchodilator effect at 24 hours was found to be suboptimal. Phase III trials using 200 and 400 μg b.i.d. have subsequently reported both clinical significant bronchodilator activities and improved patient-reported outcomes such as quality of life and dyspnea. Aclidinium bromide was also found to be safe and the anticholinergic side effects were reported to be low. Copyright 2012 Prous Science, S.A.U. or its licensors. All rights reserved.