Glycopyrrolate Improves Lung Function in COPD, Regardless of Smoking Status

Glycopyrrolate inhalation powder may improve lung function significantly in patients with moderate to severe chronic obstructive pulmonary disease (COPD) regardless of baseline smoking status, according to a study published in Respiratory Research.

COPD develops in almost 50% of smokers, with 42% of all COPD-related deaths attributable to tobacco smoking. About 40% of patients continue to smoke after COPD diagnosis, which can impair treatment efficacy.

Glycopyrrolate inhalation powder is a long-acting muscarinic antagonist medication approved by the United States Food and Drug Administration, given at a dose of 15.6 µg twice daily for long-term maintenance treatment of airflow obstruction in patients with COPD.

Researchers analyzed pooled data from two 12-week studies in 867 patients (57% current smokers; 43% former smokers) to determine the effect of smoking status on the efficacy and safety of glycopyrrolate inhalation powder compared with placebo in patients with moderate to severe COPD.

Researchers found that glycopyrrolate inhalation powder significantly improved all lung function measures, total St. George’s Respiratory Questionnaire (a disease-specific instrument designed to measure impact on overall health, daily life, and perceived well-being in patients with obstructive airways disease) score. Rescue medication use and the incidence of adverse events and serious adverse events was also similar regardless of smoking status.

Current smokers receiving background inhaled corticosteroid therapy in addition to glycopyrrolate inhalation powder had no significant improvements. Also, treatment with glycopyrrolate inhalation powder showed clinically important improvements in COPD assessment test scores, transition dyspnea index focal scores and daily symptom scores in both current and former smokers.

“These data support the use of glycopyrrolate inhalation powder twice daily in patients with moderate to severe COPD regardless of their baseline smoking status, although the magnitude of benefit may differ between current and ex-smokers,” the researchers wrote.

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