General Description

Erythro-Glycopyrronium Bromide exhibits significant therapeutic efficacy in managing Chronic Obstructive Pulmonary Disease (COPD), as demonstrated in various clinical trials. Studies such as GLOW1 and GLOW2 show its effectiveness in improving lung function over a 24-hour period compared to placebo, with GLOW3 focusing on enhanced exercise tolerance. GLOW4 highlights its efficacy in Japanese patients over a 52-week period, and GLOW5 establishes non-inferiority to tiotropium in lung function improvement and superiority in symptom reduction. Moreover, extensive safety evaluations across trials, including Phase II and III, affirm its favorable safety profile and tolerability in COPD management, making Erythro-Glycopyrronium Bromide a valuable therapeutic option.

Figure 1. Erythro-Glycopyrronium Bromide

Therapeutic Efficacy

Erythro-Glycopyrronium Bromide, a key therapeutic agent in the management of Chronic Obstructive Pulmonary Disease, has demonstrated significant therapeutic efficacy in various clinical trials. In the GLOW1 and GLOW2 Phase III studies, Erythro-Glycopyrronium Bromide was shown to improve lung function in adult patients with moderate-to-severe stable Chronic Obstructive Pulmonary Disease. These studies revealed that Erythro-Glycopyrronium Bromide increased lung function over a 24-hour period compared to placebo. The primary outcome measure was the trough Forced Expiratory Volume in 1 second (FEV1) at week 12, with key secondary outcomes including breathlessness and health status measurements. GLOW3 focused on the effect of Erythro-Glycopyrronium Bromide on exercise tolerance in Chronic Obstructive Pulmonary Disease patients, demonstrating improved exercise endurance compared to placebo. The study highlighted enhancements in exercise endurance, inspiratory capacity, and reductions in lung hyperinflation and dyspnea. In GLOW4, a 52-week study in Japanese patients with Chronic Obstructive Pulmonary Disease, Erythro-Glycopyrronium Bromide showed a clinically significant increase in pre-dose FEV1 and a high event-free rate for Chronic Obstructive Pulmonary Disease exacerbation. GLOW5, a 12-week study comparing Erythro-Glycopyrronium Bromide with tiotropium, demonstrated non-inferiority in lung function improvement and superiority in Chronic Obstructive Pulmonary Disease symptom score reduction. Erythro-Glycopyrronium Bromide also exhibited faster bronchodilation onset compared to tiotropium. Overall, Erythro-Glycopyrronium Bromide has proven to be effective in improving lung function, exercise tolerance, and reducing Chronic Obstructive Pulmonary Disease symptoms in patients, making it a valuable therapeutic option for the management of COPD. ¹

Safety and Tolerability

Erythro-Glycopyrronium Bromide, evaluated extensively for safety and tolerability in clinical trials, has demonstrated a favorable profile in the management of moderate-to-severe COPD. In Phase II studies, where a 50 mg once-daily dose was administered, Erythro-Glycopyrronium Bromide exhibited good tolerability in patients with COPD. Subsequent Phase III trials, including GLOW1–3, further confirmed its acceptable safety profile. GLOW1 and GLOW2 trials, comprising 822 and 1066 patients respectively, compared Erythro-Glycopyrronium Bromide with placebo and tiotropium over 26 and 52 weeks, showing low frequencies of cardiac and antimuscarinic side effects. The incidence of adverse events was comparable across Erythro-Glycopyrronium Bromide, placebo, and tiotropium groups, with a slightly lower rate of serious adverse events in the Erythro-Glycopyrronium Bromide group. Treatment discontinuations due to adverse events were also lower in the Erythro-Glycopyrronium Bromide group. In the GLOW5 study, which compared Erythro-Glycopyrronium Bromide with tiotropium over 12 weeks, safety was assessed through monitoring of adverse events, vital signs, and laboratory analyses. The incidence of adverse events was similar between the two treatment groups, with a low occurrence of newly occurring or worsening QT interval prolongation. Additionally, the reported death rate was low and not attributed to the study drug. Furthermore, when Erythro-Glycopyrronium Bromide was used as part of the fixed-dose LAMA/LABA treatment QVA149, no safety concerns were identified compared to tiotropium, glycopyrronium, and indacaterol. Pooled analysis across multiple safety databases reaffirmed the safety of dual bronchodilation therapy in patients with stable, moderate-to-severe COPD, with no significant increase in mortality or major cardiovascular events observed. In conclusion, Erythro-Glycopyrronium Bromide has demonstrated a good safety and tolerability profile in clinical trials, providing reassurance for its use in patients with COPD. ²

Reference

1. Riario-Sforza GG, Ridolo E, Riario-Sforza E, Incorvaia C. Glycopyrronium bromide for the treatment of chronic obstructive pulmonary disease. Expert Rev Respir Med. 2015; 9(1): 23-33.

2. D’Urzo A, Ferguson GT, van Noord JA, et al. Efficacy and safety of once-daily NVA237 in patients with moderate-to-severe COPD: the GLOW1 trial. Respir Res. 2011; 12: 156-168.