A Comparative Evaluation of Glycopyrronium Bromide, A Long-Acting Muscarinic Antagonist versus Tiotropium Bromide in Triple Therapy of COPD Patients in an Indian Clinical Setting

Abstract

Background. Current pharmacological management for patients with chronic obstructive pulmonary disease (COPD) focuses on inhaled long-acting bronchodilators, which are considered as the recommended first-line treatment option for such patients.Methods. A prospective study was conducted in 70 patients with moderate to severe COPD. Thirty-five patients (Group A) were administered daily glycopyrronium bromide (50μg) and 35 (Group B) received tiotropium bromide (18μg). Patients were assessed for forced expiratory volume in one second (FEV 1 ) score, COPD assessment scale (CAT), modified Medical Research Council (mMRC) scale, body-mass index, airflow obstruction, dyspnoea and exercise (BODE) index for COPD survival for two consecutive follow-ups after every three months of drug use. Results.Group A showed a significant improvement with respect to different evaluation methods compared to group B. Significant results were observed for group A parameters were mMRC (0.0001), CAT (0.01), BODE (0.0001) and FEV 1 (0.03). Conclusions.In patients with moderate to severe COPD, glycopyrronium bromide (50μg) once daily is found to be more beneficial than tiotropium bromide (18μg).