MTRAC issued two new Commissioning Support reviews in November 2012. The reviews cover aclidinium and glycopyrronium inhalers for COPD.
The aclidinium bromide (Eklira Genuair®) summary advises that the inhaler is suitable for prescribing in primary care but has a low place in therapy as the evidence is relatively weak. It is noted that the trials were relatively small and short in duration (12 or 24 weeks) and that there are no fully published trials comparing this treatment with other long acting bronchodilators.
The glycopyrronium bromide (Seebri Breezhaler®) summary advises that the inhaler is suitable for prescribing in primary care but has a low place in therapy. The evidence is reasonably strong and demonstrates improved lung function, reduced breathlessness and fewer hospital admissions. However, after 52 weeks of treatment there was no difference in FEV1 compared to open label tiotropium.
For both treatments it is concluded that there is insufficient evidence to support a switch in prescribing from tiotropium in patients already on treatment but they could be considered as an option when initiating treatment for a new patient.
Action: Clinicians should be aware of these reviews and compare current practice to the recommendations, making changes where appropriate.