What is the recommended use of Anoro Ellipta (umeclidinium and vilanterol) for chronic obstructive pulmonary disease (COPD) treatment?

From the Guidelines

Anoro Ellipta (umeclidinium and vilanterol) is recommended as a maintenance treatment for chronic obstructive pulmonary disease (COPD) and should be taken as one inhalation (62.5 mcg umeclidinium and 25 mcg vilanterol) once daily at the same time each day. This medication combines a long-acting muscarinic antagonist (LAMA) and a long-acting beta-2 agonist (LABA) to provide dual bronchodilation, which helps keep airways open and makes breathing easier for COPD patients. According to the most recent guidelines, including the 2018 GOLD report 1, Anoro Ellipta is not intended for acute symptom relief or as a rescue medication during sudden breathing difficulties. Patients should continue using their rescue inhaler (like albuterol) for acute symptoms. The medication should be stored at room temperature with the tray kept closed until ready for use, and the inhaler discarded six weeks after opening the foil tray or when the counter reads "0," whichever comes first. Common side effects may include pharyngitis, sinusitis, lower respiratory tract infection, constipation, diarrhea, and extremity pain. Anoro Ellipta works by relaxing airway muscles through different mechanisms - umeclidinium blocks acetylcholine receptors while vilanterol stimulates beta-2 receptors - providing complementary actions that improve lung function throughout the day. Key considerations for the use of Anoro Ellipta in COPD management are based on recommendations from various guidelines, including those from the American College of Chest Physicians and Canadian Thoracic Society 1, which emphasize the importance of preventing acute exacerbations of COPD. The choice of treatment should be individualized, taking into account the patient's symptoms, exacerbation history, and other factors such as comorbidities and potential side effects of the medication, as highlighted in the 2017 GOLD report 1. In terms of specific patient populations, guidelines suggest that combination therapies like Anoro Ellipta may be particularly beneficial for patients with a history of exacerbations or those with more severe disease, as indicated by studies such as 1 and 1. However, the decision to use Anoro Ellipta should be made on a case-by-case basis, considering the latest evidence and guidelines, including those from 2018 and later, which may provide updated recommendations on the management of COPD. For instance, the 2018 Mayo Clinic Proceedings article 1 discusses the importance of appropriately managed care and effective medical therapy for patients with COPD, emphasizing the need for a personalized approach to treatment. Ultimately, the goal of treatment with Anoro Ellipta or any other medication for COPD is to improve symptoms, reduce the risk of exacerbations, and enhance the patient's quality of life, as outlined in various guidelines and studies, including those referenced here 1.

From the FDA Drug Label

ANORO ELLIPTA is indicated for the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD). The recommended dosage of ANORO ELLIPTA for maintenance treatment of COPD is 62.5 mcg umeclidinium and 25 mcg vilanterol (1 actuation of ANORO ELLIPTA 62.5/25 mcg) once daily by oral inhalation.

The recommended use of Anoro Ellipta (umeclidinium and vilanterol) for chronic obstructive pulmonary disease (COPD) treatment is for maintenance treatment. The dosage is 62.5 mcg umeclidinium and 25 mcg vilanterol once daily by oral inhalation 2.

• Key points:
  • Maintenance treatment: Anoro Ellipta is used for long-term maintenance treatment of COPD.
  • Dosage: 62.5 mcg umeclidinium and 25 mcg vilanterol once daily.
  • Administration: Oral inhalation.
• Important considerations:
  • Not indicated for relief of acute bronchospasm or treatment of asthma.
  • Should not be initiated in patients during rapidly deteriorating or potentially life-threatening episodes of COPD 2.

From the Research

Recommended Use of Anoro Ellipta for COPD Treatment

The recommended use of Anoro Ellipta (umeclidinium and vilanterol) for chronic obstructive pulmonary disease (COPD) treatment is as a maintenance therapy to improve pulmonary function and reduce symptoms.

• Anoro Ellipta is administered once daily using the Ellipta multi-dose dry powder inhaler 3.
• The recommended dose is umeclidinium/vilanterol 62.5/25 µg, equivalent to a delivered dose of 55/22 µg once daily 3, 4.

Efficacy and Safety

Studies have shown that umeclidinium/vilanterol is effective and well-tolerated in adult patients with COPD, improving pulmonary function to a significantly greater extent than placebo and each of the individual components 3.

• Umeclidinium/vilanterol also had beneficial effects on dyspnea, use of rescue medication, exacerbations, health-related quality of life, and exercise endurance 3.
• The most common adverse events in clinical trials were headache and nasopharyngitis 3.
• Umeclidinium/vilanterol was not associated with a clinically relevant increased risk of cardiovascular adverse events in patients with COPD 3.

Patient Preference and Ease of Use

Patients with COPD have demonstrated a clear preference for the Ellipta DPI over other inhalers, such as the HandiHaler, regarding the number of steps to use, time taken to use, and ease of use 5.

• The Ellipta DPI was considered easy to use, and patients found the dose counter easy to read 5.
• Correct usage of the Ellipta DPI was high, with ≥98% of patients using the inhaler correctly 5.

Real-World Effectiveness and Safety

A post-marketing surveillance study in Korean patients with COPD found that umeclidinium/vilanterol was well-tolerated and effective, with most patients showing overall disease improvement after treatment 6.

• The overall incidence of adverse events was 28.8%, with serious adverse events and unexpected adverse events reported in 5.9% and 21.6% of patients, respectively 6.