TY  - JOUR
A1  - D’Urzo, Anthony D.
A1  - Kardos, Peter
A1  - Wiseman, Russell
T1  - Practical considerations when prescribing a long-acting muscarinic antagonist for patients with COPD
T2  - The International journal of chronic obstructive pulmonary disease
N2  - COPD is characterized by persistent airflow limitation, progressive breathlessness, cough, and sputum production. Long-acting muscarinic antagonists (LAMAs) are one of the recommended first-choice therapeutic options for patients with COPD, and several new agents have been developed in recent years. A literature search identified 14 published randomized, placebo-controlled studies of the efficacy and safety of LAMAs in patients with COPD, with improvements seen in lung function, exacerbations, breathlessness, and health status. A greater weight of evidence currently exists for glycopyrronium (GLY) and tiotropium than for umeclidinium and aclidinium, especially in terms of exacerbation reductions. To date, there have been few head-to-head clinical studies of the different LAMAs. Available data indicate that GLY and aclidinium have similar efficacy to tiotropium in terms of improving lung function, dyspnea, exacerbations, and health status. Overall, evidence demonstrates that currently available LAMAs provide effective and generally well-tolerated therapy for patients with COPD. Delivery devices for the different LAMAs vary, which may affect individual patient’s adherence to and preference for treatment. Subtle differences between individual therapeutic options may be important to individual patients and the final treatment choice should involve physician’s and patient’s experiences and preferences.
KW  - COPD
KW  - long-acting muscarinic antagonist
KW  - efficacy
KW  - safety
KW  - inhaler
KW  - adherence
Y1  - 2018
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/47583
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-475834
SN  - 1178-2005
SN  - 1176-9106
N1  - This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.
VL  - 13
SP  - 1089
EP  - 1104
PB  - DOVE Medical Press
CY  - Albany, Auckland
ER  -