Once-Daily Single Drug Works in COPD

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As we reported last month, there is significant progress being made in the treatments of chronic obstructive pulmonary disease (COPD), a group of debilitating diseases that includes emphysema and chronic bronchitis. Chronic bronchitis results from the inflammation of the lining of the bronchial tubes, which carry air to and from the lungs. Emphysema occurs when the air sacs (alveoli) at the end of the smallest air passages in the lungs are gradually and permanently destroyed. Both conditions are quite serious.

There is now another drug nearing FDA approval, which will add to the choices of therapies for COPD sufferers, and it should help with patient compliance, since it is a once-a-day single drug. Previously, COPD patients had to deal with multiple drugs and a more complicated schedule.

The drug, which received a nearly unanimous vote from an FDA advisory panel is called olodaterol (brand name is Striverdi Respimat).

ACSH s Dr. Josh Bloom says olodaterol belongs to a class of drugs called long-acting beta-2 adrenergic agonists, mercifully abbreviated LABA. LABA s when combined with an inhalable steroid have long been a first line therapy for asthma, although there have recently been safety concerns about the use of LABA s alone in the treatment of asthma.

Rick Watson, MD, a pulmonologist in Findlay, Ohio, told MedPage Today [A] once-daily LABA could have a niche to streamline the regimen for patients who don't need a twice-daily inhaled corticosteroid and are on once-daily tiotropium (Spiriva). Compliance is always an issue. Anytime you start asking people to do something more than once a day you decrease compliance."

The primary endpoint for the study was forced expiratory volume over 1 second (FEV1), a standard measure of lung function. Patients who inhaled the drug showed significantly better lung function than those who received placebo.

There are multiple bronchodilators available for the treatment of COPD. The relative utility of these therapies will only be known after post-marketing studies after many more patients have tried the drug. Whether olodaterol will be useful as a stand-alone therapy for bronchial asthma remains to be seen.

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