title: Umeclidinium/vilanterol combination inhaler efficacy and potential impact on current chronic obstructive pulmonary disease management guidelines.
abstract: BACKGROUND
  Umeclidinium bromide (UM) with vilanterol (VI) is the first once-daily long-acting muscarinic antagonist/long-acting β2 agonist (LAMA/LABA) combination approved for use in the treatment of chronic obstructive pulmonary disease (COPD) in the USA. Prior to this, only combinations of short-acting bronchodilators and short-acting muscarinic antagonists were available in the USA as a single inhaler and they required frequent dosing. LAMA or LABA therapy is the recommended first choice for moderate-to-very severe COPD with combination therapy added if monotherapy fails to control patients' symptoms. This allows lower dosing of individual medications, which may limit adverse effects. It could also have the additional benefit of improving patient compliance by making medication regimens less laboring.
  
  
  METHODS
  A comprehensive literature search of journal articles and abstracts looking for trials that evaluated both the efficacy and the safety of UM/VI revealed that UM/VI improves patients' lung function and overall health status, while maintaining excellent safety and tolerability profiles compared to placebo and other bronchodilators.
  
  
  CONCLUSIONS
  Given the clinical efficacy, favorable safety profile and ease of use, clinicians may recommend UM/VI to patients with moderate-to-very severe COPD - a shift that could have significant impact on the management of COPD.
authors.affiliation: Wake Forest School of Medicine, Medical Center Boulevard, Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy and Immunology , Winston-Salem, NC 27157-1054 , USA.
authors.forename: James F
authors.initials: JF
authors.lastname: Davidson
authors.forename: James F
authors.initials: JF
authors.lastname: Donohue
authors.forename: Jill A
authors.initials: JA
authors.lastname: Ohar
mesh_terms: D001592:Benzyl Alcohols / Q000009:adverse effects / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000009:adverse effects / Q000627:therapeutic use; D002722:Chlorobenzenes / Q000009:adverse effects / Q000627:therapeutic use*; D004338:Drug Combinations; D006801:Humans; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D011812:Quinuclidines / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D001592:Benzyl Alcohols; D001993:Bronchodilator Agents; D002722:Chlorobenzenes; D004338:Drug Combinations; C573971:GSK573719; D011812:Quinuclidines; C550468:vilanterol
keywords: bronchodilator; chronic obstructive pulmonary disease; forced expiratory volume in 1 s; forced vital capacity; long-acting muscarinic antagonist; long-acting β agonists; umeclidinium; vilanterol