Abstract

Chronic obstructive pulmonary disease (COPD) affects around 64 million people worldwide and is the fourth leading cause of death.¹ In Europe, COPD is thought to be responsible for the deaths of 200,000 to 300,000 people each year and its economic burden estimated to be EUR102 billion/year.¹ In 2011, over 1.5 million people (3.6% of the population ≥16 years) in England had COPD, which included 720,000 people aged over 65.² Drug management of COPD includes treatments to relieve respiratory symptoms, and prevent or manage acute exacerbations. Short-acting inhaled bronchodilators (either a beta₂ agonist [SABA] or muscarinic antagonist [SAMA]) are used as initial empirical treatment to relieve breathlessness and reduce exercise limitation. Long-acting bronchodilators with or without an inhaled corticosteroid (ICS) are added for people who remain breathless or have exacerbations.³ ▾Aclidinium bromide powder for inhalation (Eklira Genuair—Almirall) is a long-acting muscarinic antagonist (LAMA), licensed to be used twice a day as a maintenance bronchodilator to relieve symptoms in adults with COPD.⁴ In this article, we consider the evidence for aclidinium and how its use fits with current management strategies for COPD.