title: The role of aclidinium bromide in the treatment of chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Inhaled bronchodilators remain a cornerstone of treatment for chronic obstructive pulmonary disease (COPD); current guidelines recommend initiating inhaled bronchodilators as either monotherapy or combination therapy depending on disease severity and exacerbation risk to improve air flow and reduce breathlessness. Aclidinium bromide is a twice-daily, long-acting muscarinic antagonist recently approved in the United States and Europe and carries significant promise as an alternative long-acting inhaled antimuscarinic agent for the treatment of moderate-to-severe COPD.
  
  
  OBJECTIVE
  This review describes the pharmacology, pharmacokinetics, clinical efficacy, and adverse effects of aclidinium bromide.
  
  
  CONCLUSIONS
  Clinical trials have demonstrated improvement in forced expiratory volume in 1 second, nighttime symptom control, disease-related quality of life, and delay in time to first COPD exacerbation with aclidinium use compared with placebo. Commonly reported adverse effects include headache, nasopharyngitis, and cough. One trial reported narrow-angle glaucoma; however, no other serious adverse events have been reported to date.
  
  
  CONCLUSIONS
  Overall, aclidinium bromide has been found to be safe and effective for the treatment of moderate-to-severe COPD. Further clinical trials comparing aclidinium bromide to standard therapies are needed to fully elucidate its role in the treatment of COPD.
authors.affiliation: Assistant Clinical Professor, Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn, AL, and Adjunct Assistant Professor, Department of Internal Medicine, University of South Alabama College of Medicine, Mobile, AL. ekm0010@auburn.edu.
authors.forename: Emily M
authors.initials: EM
authors.lastname: Armstrong
authors.forename: Bradley M
authors.initials: BM
authors.lastname: Wright
authors.forename: Allison
authors.initials: A
authors.lastname: Meyer
authors.forename: Courtney S
authors.initials: CS
authors.lastname: Watts
authors.forename: Kristi W
authors.initials: KW
authors.lastname: Kelley
mesh_terms: D000328:Adult; D002986:Clinical Trials as Topic; D000075202:Contraindications; D006801:Humans; D018727:Muscarinic Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D014326:Tropanes / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D018727:Muscarinic Antagonists; D014326:Tropanes; C542859:aclidinium bromide