What is Brimica Genuair - aclidinium bromide, formoterol fumarate dihydrate - and what is it used for?
Brimica Genuair is a medicine used to relieve symptoms in adults with chronic obstructive pulmonary disease (COPD). COPD is a long-term disease in which the airways and air sacs in the lungs are damaged or blocked, causing breathing difficulties. Brimica Genuair is used for (regular) maintenance treatment. Brimica Genuair contains two active ingredients: aclidinium bromide and formoterol fumarate dihydrate .
How is Brimica Genuair used - aclidinium bromide, formoterol fumarate dihydrate?
Brimica Genuair is available as a powder for inhalation, contained in a portable inhaler device. The inhaler delivers 340 micrograms of aclidinium and 12 micrograms of formoterol fumarate dihydrate for each inhalation. The recommended dose of Brimica Genuair is an inhalation twice a day. For detailed information on the correct use of the inhaler, see the instructions in the leaflet. Brimica Genuair can only be obtained with a prescription.
How does Brimica Genuair - aclidinium bromide, formoterol fumarate dihydrate work?
The two active ingredients contained in Brimica Genuair, aclidinium bromide and formoterol fumarate dihydrate, act by keeping the airways open and allowing the patient to breathe more easily. Aclidinium bromide is a long-acting muscarinic antagonist. This means that it dilates the airways, blocking some receptors in the muscle cells of the lungs, called muscarinic receptors (also known as cholinergics), which control muscle contraction. When aclidinium bromide is inhaled, it causes the muscles in the airways to relax, helping to keep them open and allowing the patient to breathe more easily. Formoterol is a long-acting beta-2 agonist. It works by attaching to receptors known as beta-2 receptors, which are found in the airway muscles. Following binding to these receptors, it causes the muscles to relax, keeping the airways open and encouraging the patient's breathing. Long-acting muscarinic antagonists and long-acting beta-2 agonists are commonly used in combination in the management of COPD. Aclidinium bromide is authorized in the EU under the names Bretaris Genuair and Eklira Genuair from July 2012; formoterol has been marketed in the EU since the 1990s.
What benefit has Brimica Genuair shown - aclidinium bromide, formoterol fumarate dihydrate during the studies?
Brimica Genuair has been the subject of two main studies, involving over 3 400 patients with COPD, in which it was compared with aclidinium alone, formoterol alone and placebo (a dummy treatment). The main measure of effectiveness was based on changes in the forced expiratory volume of patients (FEV1, the maximum volume of air a person can exhale in one second) after six months. The results showed that, after six months of treatment, the increase in FEV1 (measured one hour after inhalation) was 293 milliliters (ml) greater with Brimica Genuair, compared to placebo, and 118 ml greater with Brimica Genuair, compared to treatment with aclidinium alone. However, the improvement compared to formoterol alone was mild and is not considered clinically significant: the FEV1 measured in the morning, before inhalation, was 68 ml greater with Brimica Genuair compared to formoterol alone. It has also been shown that Brimica Genuair increases the percentage of patients who show an improvement in breathlessness compared to placebo.
What is the risk associated with Brimica Genuair - aclidinium bromide, formoterol fumarate dihydrate?
The side effects of Brimica Genuair are similar to those reported with individual components. The most common side effects (seen in about 7 out of 100 patients) are nasopharyngitis (inflammation of the nose and throat) and headache. For the full list of all side effects reported with Brimica Genuair and restrictions, see the package leaflet.
Why has Brimica Genuair - aclidinium bromide, formoterol fumarate dihydrate - been approved?
The Agency's Committee for Medicinal Products for Human Use (CHMP) decided that Brimica Genuair's benefits are greater than its risks and recommended that it be approved for use in the EU. The CHMP noted that Brimica Genuair has been shown to significantly improve lung function in patients with COPD compared to placebo, although the improvement observed in the comparison between Brimica Genuair and one of the components alone, formoterol, was minor.
Regarding safety, the number of side effects reported with Brimica Genuair was low and did not raise substantial fears. Furthermore, the safety profile of the two components is well known and there is no evidence that the association is less safe than the individual components.
What measures are being taken to ensure the safe and effective use of Brimica Genuair - aclidinium bromide, formoterol fumarate dihydrate?
A risk management plan has been developed to ensure that Brimica Genuair is used as safely as possible. Based on this plan, safety information has been included in the summary of product characteristics and the package leaflet for Brimica Genuair, including the appropriate precautions to be followed by healthcare professionals and patients. Furthermore, as long-acting muscarinic antagonists may have an effect on the heart and blood vessels, the company that markets Brimica Genuair will provide the results of studies to further evaluate the cardiovascular safety of the medicine. Further information is available in the summary of the risk management plan.
Further information on Brimica Genuair - aclidinium bromide, formoterol fumarate dihydrate
On 19 November 2014, the European Commission issued a marketing authorization for Brimica Genuair, valid throughout the European Union. For the full version of the EPAR and the summary of Brimica Genuair's risk management plans, consult the website of the Agency: ema.Europa.eu/Find medicine / Human medicines / European public assessment reports. For more information on Brimica Genuair therapy, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist. Last update of this summary: 11-2014.
