Table 1.
Comparison of various drugs in development of combination therapy with respect to frequency of dosage, rapidity of action, and quantum of improvement in trough FEV1
| Therapies | Manufacturer | Dosage | Time to onset | Trough FEV1 (difference from placebo) |
|---|---|---|---|---|
| LABA | ||||
| Formoterol14 | Mercka | Twice daily 4.5 μg (MDI) and 12 μg (DPI) | 5 min | 50–90 mL |
| Indacaterol48 | Novartis | Once daily 150 and 300 μg (EU) (DPI) | 5 min | 130–180 mL (P<0.001) |
| Indacaterol48 | Novartis | Once daily 75 μg (US) (DPI) | 5 min | ≥120 mL (P<0.001) |
| Olodaterol49 | Boehringer Ingelheim | Once daily 5 and 10 μg (Respimat®) | Not available | 61–132 mL (P<0.01) |
| Vilanterol50 | GSK | Once daily 25 and 50 μg (DPI) | Median 6 min | 137–165 mL (P<0.001) |
| LAMA | ||||
| Aclidinium18,51 | Almirall/Forest Laboratories | Twice daily 200–400 μg (DPI) | 10–30 min | 86–124 mL (P<0.0001) |
| Glycopyrronium52,53 | Novartis | Once daily 50 μg (DPI) | 5 min | 91–108 mL (P<0.001) |
| Glycopyrrolate52 | Pearl Therapeutics | Twice daily 36 μg (MDI) | 5 min | Statistically superior to placebo (P<0.0001) |
| GSK23370554 | GSK | Twice daily 200 μg | Not available | 130 mL (P<0.001) |
| Tiotropium55 | Boehringer Ingelheim | Once daily 18 μg (DPI) and 5 μg (SMI) | 15 min | 120–150 mL (P<0.001) |
Notes:
a
Other companies are developing formoterol as part of a fixed-dose combination. Adapted from Tashkin DP, Ferguson GT. Combination bronchodilator therapy in the management of chronic obstructive pulmonary disease. Respir Res. 2013;14:49.56
Abbreviations: FEV1, forced expiratory volume in 1 second; MDI, metered dose inhaler; DPI, dry powder inhaler; SMI, Soft Mist™ inhaler; LABA, long-acting β2 agonist; LAMA, long-acting muscarinic antagonist; EU, European Union.