Cardiovascular Safety of Two Bronchodilators’ Fixed-Dose Combination: Indacaterol and Glycopyrronium

Abstract

Combination therapy with anticholinergics and β2-agonists should be used in COPD patients after failure of previous monotherapy with one of these drugs. Synergistic effect of both mechanisms of bronchodilation can maximize the efficacy of separately administered drugs. The effectiveness of the combination of LABA and LAMA is already confirmed, nevertheless the question about the safety profile of this therapy is still remaining, particularly with regard to the cardiovascular system. The paper discusses the overall safety profile of the combined preparation compare to placebo as well as the active comparators, especially the cardiovascular safety of fixed-dose formulation. Based on the data it has been demonstrated, that the combination of two ultra-long-acting bronchodilators with different complementary mechanisms of action increases the effectiveness of COPD therapy without affecting the safety.

<p>Absence of Adverse Effects of Tiotropium/Olodaterol Compared with the Monocomponents on Long-Term Heart Rate and Blood Pressure in Patients with Moderate-to-Very-Severe COPD</p>

“…This is in line with previous studies investigating other LAMA/LABA combinations, which also concluded that the rate of cardiovascular adverse events was comparable with both placebo and monotherapies. 31,32 Furthermore, studies assessing combined LABA/ICS treatment have shown it to be well tolerated, with no adverse effects on mortality or cardiovascular outcomes. 33,34 Some studies, such as the CLAIM study 21 and a further study by Stone et al, 22 have also suggested that bronchodilation can have a positive effect on heart function by reducing hyperinflation.…”