title: Patient-reported outcomes and considerations in the management of COPD: focus on aclidinium.
abstract: Chronic obstructive pulmonary disease (COPD) is a complex heterogeneous disease, in which several factors combine to give the final clinical expression. Both early and more recent studies have shown that forced expiratory volume in one second (FEV1), despite being an extremely important parameter to predict the progression of the disease, is a poor surrogate marker for symptoms perception. Accordingly, patient-reported outcomes (PROs) have gained popularity as a measure of the impact of treatment from the patients' perspective, since they represent the individuals' perception of their health status, beyond any physiological limitations. Several such PROs, therefore, are currently included in multidimensional COPD evaluation. This multidimensional approach helps identify different patient types and individualize, up to a certain point, pharmacological treatment. In this multidimensional approach it is important to highlight the importance of long-acting bronchodilators in COPD treatment strategies. Long-acting bronchodilators are cost-effective and have been shown to achieve the greatest functional and clinical improvements in COPD. As a result, long-acting bronchodilators are now the main pharmacological treatment for COPD at all stages of the disease. Until recently, tiotropium was the leading bronchodilator for the treatment of COPD. The clinical development of this medication, unprecedented in inhaled therapy, involved tens of thousands of patients and yielded consistent outcomes in terms of lung function, symptoms, quality of life, exacerbations, and prognosis. However, new long-acting bronchodilators have recently been developed or are currently under development. In this review, we evaluate the effects of aclidinium bromide, a novel long-acting bronchodilator, on PROs in COPD. Aclidinium is a novel long-acting muscarinic antagonist with a good safety profile for the treatment of COPD, and has proven efficacy in both objective functional measurements and PROs. Comparison studies with tiotropium have shown it to have similar lung function improvement and a similar impact on PROs, including quality of life or symptom perception.
authors: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, Spain ; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
authors: Jose Luis
authors: JL
authors: Lopez-Campos
authors: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, Spain ; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
authors: Carmen
authors: C
authors: Calero
authors: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, Spain.
authors: Cecilia
authors: C
authors: Lopez-Ramirez
authors: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, Spain.
authors: Maria Isabel
authors: MI
authors: Asensio-Cruz
authors: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, Spain.
authors: Eduardo
authors: E
authors: Márquez-Martín
authors: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, Spain ; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
authors: Francisco
authors: F
authors: Ortega-Ruiz
keywords: aclidinium; bronchodilators; chronic obstructive pulmonary disease; patient-reported outcomes
references: Curr Med Res Opin. 2014 Jul;30(7):1427-36
references: 24666181
references: Chron Respir Dis. 2013 Feb;10(1):11-8
references: 23149384
references: Thorax. 2003 Apr;58(4):339-43
references: 12668799
references: Int J Clin Pharmacol Ther. 2012 Jun;50(6):403-12
references: 22541745
references: COPD. 2012 Jun;9(3):251-8
references: 22497533
references: Proc R Soc Med. 1952 Sep;45(9):577-84
references: 13003946
references: Eur Respir J. 2012 Feb;39(2):265-71
references: 21700602
references: Med Sci Sports. 1973 Summer;5(2):90-3
references: 4721012
references: Eur J Health Econ. 2007 Jun;8(2):123-35
references: 17370096
references: N Engl J Med. 2008 Oct 9;359(15):1543-54
references: 18836213
references: J Med Econ. 2011;14(4):486-96
references: 21679019
references: Eur Respir J. 2011 Feb;37(2):264-72
references: 21115606
references: J Pain Symptom Manage. 2009 Jan;37(1):107-28
references: 19111779
references: Am J Respir Crit Care Med. 2013 Feb 15;187(4):347-65
references: 22878278
references: Respir Res. 2014 Jun 14;15:66
references: 24929799
references: Eur Respir J. 2014 Nov;44(5):1223-33
references: 25034563
references: Thorax. 2009 Nov;64(11):939-43
references: 19703830
references: Clin Infect Dis. 1994 Jan;18 Suppl 1:S79-83
references: 8148458
references: J Gen Intern Med. 2012 Nov;27(11):1506-12
references: 22782274
references: Lancet. 2012 Dec 15;380(9859):2095-128
references: 23245604
references: Ther Adv Chronic Dis. 2014 Mar;5(2):85-98
references: 24587893
references: Int J Chron Obstruct Pulmon Dis. 2014 Sep 25;9:1021-31
references: 25285002
references: Am J Respir Crit Care Med. 2012 Feb 15;185(4):435-52
references: 22336677
references: COPD. 2013 Aug;10(4):511-22
references: 23819698
references: Am J Respir Crit Care Med. 2007 Sep 15;176(6):532-55
references: 17507545
references: Expert Opin Drug Deliv. 2013 Aug;10(8):1023-31
references: 23745954
references: Respir Med. 2008 Nov;102(11):1545-55
references: 18662868
references: N Engl J Med. 2013 Oct 17;369(16):1491-501
references: 23992515
references: Chest. 2012 Mar;141(3):745-752
references: 21903737
references: Eur Respir J. 2013 Dec;42(6):1472-83
references: 23722617
references: BMC Res Notes. 2014 Aug 23;7:562
references: 25148698
references: Health Qual Life Outcomes. 2003 Apr 28;1:13
references: 12773199
references: J Aerosol Med Pulm Drug Deliv. 2014 Feb;27(1):43-50
references: 23521168
references: Respir Med. 1991 Sep;85 Suppl B:25-31; discussion 33-7
references: 1759018
references: Respir Med. 2013 Dec;107(12):1957-65
references: 23916502
references: Arch Bronconeumol. 2012 Sep;48(9):331-7
references: 22341911
references: Lancet Respir Med. 2014 Jan;2(1):54-62
references: 24461902
references: Eur Respir J. 2003 Feb;21(2):267-72
references: 12608440
references: Arch Bronconeumol. 2014 Jan;50 Suppl 1:1-16
references: 24507959
references: Eur Respir J. 2014 Nov;44(5):1156-65
references: 25234803
references: Health Qual Life Outcomes. 2013 Jun 25;11:104
references: 23799883
references: Curr Med Res Opin. 2009 Aug;25(8):2043-8
references: 19569976
references: COPD. 2014 Aug;11(4):459-67
references: 24568374
references: Int J Chron Obstruct Pulmon Dis. 2012;7:697-709
references: 23093901
references: Respir Med. 2009 Dec;103(12):1832-7
references: 19651504
references: COPD. 2014 Sep;11(5):591-602
references: 24914771
references: Ann Behav Med. 2012 Aug;44(1):66-72
references: 22422104
references: Eur J Clin Pharmacol. 2012 Oct;68(10):1365-73
references: 22476392
references: Eur Respir J. 2010 Jul;36(1):96-104
references: 19897551
references: Eur Respir J. 2008 Apr;31(4):869-73
references: 18216052
references: Respiration. 2009;78(3):322-8
references: 19451700
references: Eur Respir J. 2014 Mar;43(3):754-62
references: 23988775
references: Int J Nurs Stud. 2013 May;50(5):688-707
references: 22921317
references: Respir Med. 2014 Feb;108(2):358-65
references: 24209768
references: Thorax. 1987 Oct;42(10):773-8
references: 3321537
references: Clin Drug Investig. 2013 Dec;33(12):893-904
references: 24085591
references: Eur Respir J. 2012 Oct;40(4):830-6
references: 22441743
references: Rehabil Nurs. 1989 Nov-Dec;14(6):323-5
references: 2813949
references: Health Qual Life Outcomes. 2009 Dec 07;7:98
references: 19968881
references: Respiration. 2011;82(4):328-34
references: 21454953
references: COPD. 2010 Oct;7(5):331-6
references: 20854047
references: N Engl J Med. 1999 Jun 24;340(25):1948-53
references: 10379018
references: J Pharmacol Exp Ther. 2009 Nov;331(2):740-51
references: 19710368
references: Eur Respir J. 2014 Aug;44(2):341-50
references: 24876173
references: J Psychosom Res. 2013 Dec;75(6):563-71
references: 24290047
references: Chest. 1984 Jun;85(6):751-8
references: 6723384
references: Eur Respir J. 2009 Sep;34(3):648-54
references: 19720809
references: Thorax. 2009 Nov;64(11):950-5
references: 19720608
references: Respir Med. 2009 Jul;103(7):1004-12
references: 19269150
references: COPD. 2013 Aug;10(4):500-10
references: 23679347
references: Eur J Pharm Sci. 2010 Mar 18;39(5):283-90
references: 20093184
references: Ann Intern Med. 2012 Dec 4;157(11):785-95
references: 22964778
references: Med Clin North Am. 2012 Jul;96(4):767-87
references: 22793944
references: COPD. 2012 Apr;9(2):90-101
references: 22320148
references: Cochrane Database Syst Rev. 2014 Sep 19;(9):CD010509
references: 25234126