Profile of aclidinium bromide in the treatment of chronic obstructive pulmonary disease

Abstract

Bronchodilators provide the mainstay of pharmacologic therapy for chronic obstructive pulmonary disease (COPD), and anticholinergic bronchodilators, in particular, appear to be the most effective. There are currently two anticholinergic agents available in the US for the treatment of COPD (ipratropium bromide and tiotropium bromide), but several others are in various stages of development. Aclidinium bromide, a novel, long-acting, anticholinergic bronchodilator, is currently in Phase III trials for the management of COPD. Available evidence suggests that aclidinium is a safe and well tolerated drug with a relatively rapid onset and a sufficient duration of action to provide once-daily dosing. This article will provide a pharmacologic profile of aclidinium bromide and review the preclinical and clinical studies evaluating its safety and efficacy in the treatment of COPD.

Keywords: aclidinium bromide; bronchodilators; chronic obstructive; muscarinic antagonists; pharmacokinetics; pharmacology; pulmonary disease.

Figure 1

Muscarinic receptor subtypes in the human airway. Reproduced with permission. Barnes PJ. The role of anticholinergics in chronic obstructive pulmonary disease. Am J Med. 2004;117 Suppl 12A:24S–32S. Copyright © 2004, with permission from Elsevier.

Figure 2

Chemical structure of aclidinium bromide. Reproduced with permission. Gavalda A, Miralpeix M, Ramos I, et al. Characterization of aclidinium bromide, a novel inhaled muscarinic antagonist, with long duration of action and a favorable pharmacological profile. J Pharmacol Exp Ther. 2009;331(2):740–751. © American Society for Pharmacology and Experimental Therapeutics.