Chronic obstructive pulmonary disease (COPD)

is a long-term inflammatory lung disease that causes persistent respiratory symptoms and airflow limitation due to airway abnormalities often resulting from significant exposure to noxious particles or gases. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. The main risk factor for COPD is tobacco smoking, but other environmental exposures such as fuel exposure and air pollution may contribute. Aside from exposures, individual patient factors, such as genetic abnormalities, abnormal lung development and accelerated aging, predispose individuals to develop COPD as well.

COPD is associated with significant concomitant chronic diseases, which increase its morbidity and mortality. Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions. Although COPD is a progressive disease that gets worse over time, it is treatable. With proper management, most people with COPD can achieve good symptom control and quality of life, as well as reduced risk of other associated conditions.

According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines for COPD

1. long-acting beta-2 agonists (LABAs) may be used as initial monotherapy in patients in Groups A and B.
2. In Group C patients, long-acting muscarinic antagonists (LAMAs) are preferred as initial therapy over LABAs due to effectiveness in preventing exacerbations.
3. In Group D patients, LABAs are used as initial therapy in combination with inhaled corticosteroids (ICS) or LAMAs. If the patient has exacerbations, triple therapy with a LAMA, a LABA, and ICS can be considered.

Duaklir [aclidinium/formoterol] is a combination of aclidinium, a respiratory long-acting muscarinic antagonist (LAMA), and formoterol, a long-acting beta-2 agonist (LABA) that is FDA approved for the maintenance treatment of chronic obstructive pulmonary disease (COPD) in adults. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, Duaklir [aclidinium/formoterol] may be used as initial therapy for patients in group D (those with a high risk of exacerbation). Duaklir [aclidinium/formoterol] is not approved for the treatment of asthma and should not be used to treat acute bronchospasm. Both LAMAs and LABAs reduce the risk of COPD exacerbations. LAMA/LABA combination therapy is associated with greater improvements in lung function compared to monotherapy.

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