From the Guidelines
Trimbow (formoterol, glycopyrronium, beclometasone) is used for the long-term control of asthma symptoms.
Key Components and Mechanisms
- Formoterol is a long-acting β2-agonist (LABA) that provides bronchodilation for at least 12 hours after a single dose 1.
- Glycopyrronium is an anticholinergic that inhibits muscarinic cholinergic receptors, reducing intrinsic vagal tone of the airway 1.
- Beclometasone is an inhaled corticosteroid (ICS) that reduces airway hyperresponsiveness, inhibits inflammatory cell migration and activation, and blocks late-phase reaction to allergen 1.
Usage Guidelines
- LABAs, such as formoterol, should not be used as monotherapy for long-term control of asthma and should be used in combination with ICSs, like beclometasone, for moderate or severe persistent asthma 1.
- The daily use of LABA generally should not exceed 100 mcg salmeterol or 24 mcg formoterol 1.
- Patients should be instructed not to stop ICS therapy while taking LABA, even though their symptoms may significantly improve 1.
Clinical Context
- Trimbow is likely used for patients whose asthma is not adequately controlled with low-dose ICSs alone, requiring step 3 care or higher 1.
- The combination of LABA and ICS in Trimbow may help reduce the incidence of asthma exacerbations, particularly in patients with moderate to severe persistent asthma 1.
From the Research
Trimbow Usage
- Trimbow, a combination of formoterol, glycopyrronium, and beclometasone, is used for the treatment of chronic obstructive pulmonary disease (COPD) 2, 3, 4, 5, 6.
Indications
- It is specifically indicated for patients with severe and very severe COPD who have exacerbations despite treatment with LABA-LAMA or LABA-ICS 2, 4.
- The European Medicines Agency has granted marketing authorisation for Trimbow for the treatment of COPD in patients not adequately treated with a combination of an inhaled corticosteroid and a long-acting beta2 agonist 6.
Mechanism of Action
- The combination of beclomethasone dipropionate, formoterol fumarate, and glycopyrronium bromide in Trimbow has a synergistic effect on human airway smooth muscle, leading to relaxation of medium bronchi and small airways 3.