What is the use of Brovana (arformoterol)?

From the Guidelines

Brovana (arformoterol) is recommended as a long-acting beta-2 agonist (LABA) for the treatment of chronic obstructive pulmonary disease (COPD) to reduce the risk of acute exacerbations and improve quality of life, as evidenced by a systematic review and guideline recommendation 1.

Key Points

• Brovana is administered via nebulizer, typically at a dose of 15 mcg twice daily (once in the morning and once in the evening) 1.
• It works by relaxing the muscles around the airways, making breathing easier for patients with COPD.
• Brovana is not intended for use as a rescue medication for sudden breathing problems but rather as a maintenance treatment.
• Patients should continue using their rescue inhalers as needed for acute symptoms.
• Brovana should not be used alone for asthma treatment due to increased risk of asthma-related death when LABAs are used without inhaled corticosteroids in asthma patients.

Benefits and Safety

• The use of long-acting beta-2 agonists, such as Brovana, has been shown to reduce the rate of acute exacerbations of COPD, both moderate and severe, compared to placebo 1.
• Brovana has also been shown to improve quality of life, as measured by the SGRQ, with a significant improvement in SGRQ score compared to placebo 1.
• The safety of Brovana has been established, with a similar rate of adverse events compared to placebo, and no significant difference in mortality 1.

Comparison to Other Treatments

• A systematic review comparing long-acting muscarinic antagonists to long-acting beta-2 agonists, such as Brovana, found that tiotropium was associated with a lower rate of exacerbations compared to long-acting beta-2 agonists, but the strength of this evidence was deemed moderate due to a serious risk of bias 1.
• However, the guideline recommendation still supports the use of long-acting beta-2 agonists, such as Brovana, as a treatment option for COPD, due to their established benefits in reducing exacerbations and improving quality of life 1.

From the FDA Drug Label

Arformoterol tartrate inhalation solution is a long-acting beta2-adrenergic agonist (beta2-agonist) indicated for: Long-term, twice daily (morning and evening) administration in the maintenance treatment of bronchoconstriction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. Important limitations of use: Arformoterol tartrate inhalation solution is not indicated to treat acute deteriorations of chronic obstructive pulmonary disease. Arformoterol tartrate inhalation solution is not indicated to treat asthma.

The drug Brovana is also known as arformoterol (INH), and it is used for the maintenance treatment of bronchoconstriction in patients with chronic obstructive pulmonary disease (COPD). The main indications are:

• Long-term treatment of bronchoconstriction in patients with COPD, including chronic bronchitis and emphysema. The important limitations of use are:
• Not indicated to treat acute deteriorations of chronic obstructive pulmonary disease.
• Not indicated to treat asthma 2 2.

From the Research

Brovana Overview

• Brovana, also known as arformoterol, is a long-acting beta-2 agonist used in the management of chronic obstructive pulmonary disease (COPD) 3.
• It is delivered via a nebulizer and is used to improve lung function and reduce symptoms in patients with COPD 3, 4.

Efficacy and Safety

• Studies have shown that arformoterol is effective in improving lung function and reducing symptoms in patients with COPD 3, 4.
• The safety profile of arformoterol is similar to that of other long-acting beta-2 agonists, with few adverse cardiovascular events 5.
• Arformoterol has been shown to reduce the rate and risk of exacerbations in patients with COPD 4, 6.

Treatment Patterns

• Medicare beneficiaries who initiated nebulized arformoterol therapy had more exacerbations and hospitalizations than controls 90 days prior to initiation 4.
• The use of arformoterol as a maintenance therapy for COPD is supported by evidence-based treatment guidelines 4, 5.
• Arformoterol can be used in combination with other agents, such as inhaled corticosteroids and long-acting muscarinic antagonists, to provide additional benefits for patients with COPD 5, 6.

Comparison to Other Treatments

• Arformoterol has been compared to other long-acting beta-2 agonists, such as formoterol, and has been shown to have similar efficacy and safety profiles 5.
• Ensifentrine, a novel PDE3/PDE4 inhibitor, has been shown to be effective in patients with COPD taking long-acting bronchodilators, including arformoterol 6.