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Glycopyrronium for chronic obstructive pulmonary disease: evidence and rationale for use from the GLOW trials

Marc Miravitlles, Kai-Michael Beeh & Pablo Altman

The clinical development of the long-acting muscarinic antagonist bronchodilator glycopyrronium (Seebri® Breezhaler® inhalation powder) in the GLOW (glycopyrronium bromide in chronic obstructive pulmonary disease airways) series of studies showed that, compared with placebo, once-daily glycopyrronium provided 24-h bronchodilation, improved symptoms and health status and reduced the risk and rate of moderate or severe exacerbations. Glycopyrronium also reduced dynamic hyperinflation and increased exercise tolerance. Compared with the longacting muscarinic antagonist tiotropium, glycopyrronium had a similar effect on clinical outcomes with a faster onset of action. Added to the long-acting β2-agonist bronchodilator indacaterol, glycopyrronium had a greater bronchodilator effect and improved dyspnea versus indacaterol alone. There were no significant safety issues in the GLOW studies. Glycopyrronium is a useful addition to the treatments for chronic obstructive pulmonary disease.