What is the classification of Brovana (arformoterol)?

From the Guidelines

Brovana (arformoterol tartrate) is classified as a long-acting beta-2 agonist (LABA) bronchodilator medication, primarily used to treat chronic obstructive pulmonary disease (COPD) by relaxing the smooth muscles in the airways and making breathing easier for patients with COPD. It belongs to the class of long-acting beta-adrenergic agonists, which work by stimulating beta-2 receptors in airway smooth muscle, increasing cyclic AMP levels, and leading to bronchodilation 1.

Key Characteristics of Brovana

• Typically administered via nebulization twice daily (15 mcg/2 mL solution)
• Not indicated for the treatment of asthma or acute bronchospasm
• Provides sustained bronchodilation over 12 hours, unlike short-acting beta agonists like albuterol which provide quick relief
• Should always be used as part of a comprehensive COPD management plan, often alongside inhaled corticosteroids or anticholinergic medications

Clinical Use and Recommendations

• Patients with moderate to severe COPD may benefit from the use of long-acting beta-agonists like Brovana to prevent moderate to severe acute exacerbations of COPD, as recommended by guidelines 1
• The medication should not be used as a rescue medication and may increase the risk of asthma-related death when used without proper controller medications in asthma patients
• The choice of treatment should be based on individual patient needs and preferences, taking into account the severity of symptoms, risk of exacerbations, and presence of comorbidities

Guidelines and Recommendations

• National guidelines for the management of COPD recommend the use of long-acting beta-agonists like Brovana as part of a comprehensive treatment plan, often in combination with other medications such as inhaled corticosteroids or anticholinergic agents 1
• The specific recommendations for the use of Brovana and other LABAs may vary depending on the country and region, as well as the individual patient's needs and circumstances.

From the FDA Drug Label

Arformoterol, the (R,R)-enantiomer of formoterol, is a selective long-acting beta2- adrenergic receptor agonist (beta2-agonist)

• Brovana class: Long-acting beta2-adrenergic receptor agonist (LABA) 2

From the Research

Brovana Class

• Brovana is a long-acting beta2-agonist (LABA) used in the treatment of chronic obstructive pulmonary disease (COPD) 3, 4, 5.
• LABAs, including Brovana, are effective in improving quality of life and reducing exacerbations, including those requiring hospitalization, in patients with moderate to severe COPD 3.
• The use of LABAs, such as Brovana, is associated with improved lung function, health status, and reduced rate of exacerbations 4.
• Brovana, specifically, is the (R,R)-enantiomer of formoterol and is available for use as a nebulized solution, providing an alternative option for patients who cannot use conventional inhaler devices 5.
• Studies have shown that Brovana is as effective as other available long-acting inhaled beta2-agonists in improving lung function and symptoms in patients with COPD 5.
• The safety of Brovana for long-term administration has been documented, and it is an effective option for patients with COPD who require sustained bronchodilation delivered through nebulization 5.

Comparison with Other LABAs

• Comparisons between different LABA combinations, including Brovana, have shown that they may have similar effects on reducing exacerbations and improving quality of life in patients with COPD 6.
• However, more research is needed to guide clinicians in selecting the most appropriate LABA combination for their patients, as current evidence is limited 6.
• Salmeterol, another LABA, has been shown to be an effective bronchodilator with a consistent effect over a 12-week study in patients with COPD, including those "unresponsive" to albuterol 7.