Some COPD Patients Benefit from Aclidinium Bromide Treatment

Certain patients with chronic obstructive pulmonary disease (COPD) may benefit from treatment with aclidinium bromide, according to findings from the German Institute for Quality of Efficiency in Health Care (IQWiG).

Aclidinium bromide, also known as Eklira, Bretaris, has been approved since July 2012 for the relief of COPD symptoms in adults. But IQWiG reevaluated the benefit of the drug due to the Act on the Reform of the Market for Medicinal Products (AMNOG). Their first paper on the topic (examining aclidinium bromide as monotherapy in 2012) did not see added benefit from aclidinium bromide for COPD patients. Another paper in 2015 examined aclidinium bromide for the fixed dose combination determined that there was an added benefit for COPD patients, but this examination revealed new observations.

In a study with the Federal Joint Committee (G BA), patients with COPD grade II used long-acting beta 2 sympathomimetic (like formoterol) and/ or tiotropium, while grade III patients with at least two exacerbations per year used an inhaled corticosteroid. The manufacturer company reported that no sufficient new evidence was gathered for grade III patients, which therefore did not merit any further assessment.

So, the researchers determined that adult patients with grade III COPD with fewer than two exacerbations per year had fewer flare ups when using aclidinium bromide when compared to grade III patients on formoterol. However, the researchers called these mixed results about the outcome, saying that the outcomes of the use of aclidinium bromide depended largely o the severity of the COPD disease. There was no advantage for grade II COPD patients taking aclidinium bromide.

Further analysis did not show any relevant differences between the treatment groups or the findings were too similar to show any clear direction, the researchers reported.

There was no data about patients with COPD grade IV with fewer than two exacerbations per year, which is why the researchers were unable to determine any clear benefits for patients outside of grade III. No other patient group seemed to glean any benefit from aclidinium bromide.