Umeclidinium (brand name Incruse Ellipta, from GSK) is an anticholinergic medicine used as a long-term treatment in people with COPD. It works because it relaxes and opens the airways to the lungs and makes breathing easier.

How does umeclidinium for COPD work?

Umeclidinium is a long-acting muscarinic antagonist, also known as an anticholinergic. It connects to the muscarinic receptors subtypes M1 to M5. The M3 receptors are located in the muscle of the bronchi, and are responsible for bronchoconstriction. As umeclidinium has affinity to the M3 receptors, it works by inhibiting them on the muscle of the bronchi, leading to bronchodilation.

Studies of umeclidinium

The FDA approval of umeclidinium was based on different dose-ranging studies in 624 participants with COPD, and two placebo-controlled confirmatory studies in more than 1,700 participants with COPD.

The dose-ranging trials were conducted in people with COPD over seven days and evaluated four different doses of umeclidinium (from 15.6 to 125 mcg) or a placebo once daily. The 62.5 mcg and 125 mcg doses had greater improvements in FEV1 (forced expiratory volume in one second, a measure of lung function) after 24 hours compared to the 15.6 and 31.25 mcg ones.

The placebo-controlled confirmatory trials studied effectiveness on lung function, with the 62.5 mcg dose showing a greater improvement on trough FEV1 compared to a placebo.

Indications and side effects

Umeclidinium comes as a powder to inhale by mouth once daily.

Most common side effects include upper respiratory tract infection, stuffy or runny nose, cough, sore throat, joint and muscle pain, tooth pain, stomach pain, bruising or dark areas of the skin, and fast or irregular heartbeat.

 

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