Aclidinium for COPD?

Chronic obstructive pulmonary disease (COPD) affects around 64 million people worldwide and is the fourth leading cause of death.(1) In Europe, COPD is thought to be responsible for the deaths of 200,000 to 300,000 people each year and its economic burden estimated to be EUR102 billion/year.(1) In 2011, over 1.5 million people (3.6% of the population ≥ 16 years) in England had COPD, which included 720,000 people aged over 65.(2) Drug management of COPD includes treatments to relieve respiratory symptoms, and prevent or manage acute exacerbations. Short-acting inhaled bronchodilators (either a beta2 agonist [SABA] or muscarinic antagonist [SAMA]) are used as initial empirical treatment to relieve breathlessness and reduce exercise limitation. Long-acting bronchodilators with or without an inhaled corticosteroid (ICS) are added for people who remain breathless or have exacerbations.(3) Aclidinium bromide powder for inhalation (Eklira Genuair-Almirall) is a long-acting muscarinic antagonist (LAMA), licensed to be used twice a day as a maintenance bronchodilator to relieve symptoms in adults with COPD.(4) In this article, we consider the evidence for aclidinium and how its use fits with current management strategies for COPD.