title: Aclidinium bromide for the treatment of chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Although there are some challenges with current therapies, the growing evidence that tiotropium bromide is important in the maintenance treatment of chronic obstructive pulmonary disease (COPD) has led to enthusiastic investigation in search of novel muscarinic antagonists which share some of the beneficial characteristics of tiotropium and perhaps improve upon less desirable ones.
  
  
  METHODS
  Aclidinium bromide is a new muscarinic antagonist that has been developed to relieve symptoms in patients with COPD. Preclinical data showed that it has an intriguing pharmacodynamic and pharmacokinetic profile. Aclidinium bromide was initially assessed as a once-daily bronchodilator. Subsequently, it has been evaluated as a twice-daily agent to increase the size of the clinical effect. Pivotal Phase III trials have documented that aclidinium bromide 400 μg twice-daily shows clinically meaningful effects in lung function and other important supportive outcomes, such as health-related quality of life, dyspnea and night-time/early morning symptoms, and is safe.
  
  
  CONCLUSIONS
  Aclidinium bromide can to be used as an alternative to tiotropium or a long-acting β₂-agonist. It is likely that the device used to deliver aclidinium, Genuair inhaler, a novel, multidose and a breath-actuated dry powder inhaler (DPI), will be important for the possible success of this drug. However, additional Phase III trials to assess advantages over tiotropium bromide and long-acting β₂-agonists are required to allow the place of aclidinium bromide to be fully elucidated.
authors.affiliation: University of Rome 'Tor Vergata', Department of System Medicine, Unit of Respiratory Clinical Pharmacology, Italy. mario.cazzola@uniroma2.it
authors.forename: Mario
authors.initials: M
authors.lastname: Cazzola
authors.forename: Clive P
authors.initials: CP
authors.lastname: Page
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Matera
mesh_terms: D000280:Administration, Inhalation; D000818:Animals; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D017326:Clinical Trials, Phase III as Topic; D058995:Dry Powder Inhalers; D006801:Humans; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D011788:Quality of Life; D012602:Scopolamine Derivatives / Q000008:administration & dosage / Q000627:therapeutic use; D000069447:Tiotropium Bromide; D014326:Tropanes / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D001993:Bronchodilator Agents; D018727:Muscarinic Antagonists; D012602:Scopolamine Derivatives; D014326:Tropanes; C542859:aclidinium bromide; D000069447:Tiotropium Bromide