• Expert Opin Drug Saf · Mar 2015

    Review

    Review of drug safety and efficacy of arformoterol in chronic obstructive pulmonary disease.

    • Chee H Loh, James F Donohue, and Jill A Ohar.
    • Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard , Winston-Salem, NC 27157-1054 , USA.
    • Expert Opin Drug Saf. 2015 Mar 1; 14 (3): 463-72.

    IntroductionThe global initiative for chronic obstructive lung disease guidelines recommend maintenance therapy using long-acting bronchodilators for patients with chronic obstructive pulmonary disease (COPD) who have daily symptoms. Arformoterol is the (R, R) - enantiomer of the racemic formoterol and is more potent than (R, R/ S, S) - formoterol.Areas CoveredCurrently, arformoterol is one of two nebulized long-acting β-agonists on the market. It has a low incidence of cardiovascular side effects with incidence of arrhythmia and ischemia similar to placebo. β-adrenergic adverse effects are infrequent, numerically lower than formoterol, but have a quicker onset of action than salmeterol. There was no observed clinical tolerance over 12 months. arformoterol is safe in combination therapy with inhaled corticosteroids, tiotropium and rescue inhalers. A 12-month Phase IV trial found no increased risk of respiratory death or COPD exacerbation-related hospitalizations. arformoterol can potentially benefit patients with hyperinflation and low inspiratory flow rates.Expert OpinionThe introduction of the centers for medicare and medicaid services penalization for COPD readmissions may boost the appeal of long-acting bronchodilators as new discharge medications. With the advent of ultra long-acting bronchodilators, its potential as a once daily agent in isolation or combination with these new therapies needs further study.

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