Looking for an appropriate COPD treatment?


Sunovion has a range of maintenance therapies for patients with COPD, including chronic bronchitis and/or emphysema, to help you provide personalized care.

Get to know our diverse COPD portfolio

  • Our portfolio
  • Therapies by device
  • Therapies by class
  • GOLD Report Summary
  • Treating LTC residents

Therapies by Delivery Type

Handheld (NEOHALER)

  • Small and portable
  • Breath-actuated
  • Audio and visual feedback mechanisms
    • Whirring noise on inhalation confirms capsule is correctly placed
    • Clear capsule allows patient to see if there is any residual medication

Vibrating Membrane Nebulizer

  • Small* and portable
  • Can be used with 4 AA batteries or an AC adapter
  • Audiovisual feedback mechanisms
    • Patients will hear 2 beeps and green LED light will turn off when the device has completed its administration cycle
  • Two- to- 3-minute administration with proper assembly and cleaning
  • Tidal breathing
  • Allows inhalation of medicine independent of inspiratory flow rate

Nebulized

  • Used with a standard jet nebulizer
  • Twice-daily dosing
  • Five- to 10-minute administration
  • Tidal breathing
  • Allows inhalation of medicine independent of inspiratory flow rate

Sunovion LABA & LAMA Bronchodilator Treatment Options

Each COPD patient's needs are different. Sunovion has a range of COPD maintenance options to help you select an appropriate medication and delivery device.

Patients with COPD are commonly prescribed one or both of these types of long-acting bronchodilators:

LABA/LAMA

LABA/LAMA work by using 2 classes of bronchodilators.

LAMA

LAMAs work by inhibiting COPD-mediated bronchoconstriction.

LABA

LABAs cause a series of physiological reactions resulting in smooth muscle relaxation.

These maintenance medications should not be used for the relief of acute symptoms, ie, as rescue therapy for the treatment of acute episodes of bronchospasm. Acute symptoms should be treated with an inhaled, short-acting beta2-agonist.

The GOLD Report recommends bronchodilators—individually or in combination—as integral to long-term COPD maintenance therapy.

See GOLD Report Summary

GOLD does not endorse any specific treatments.

The GOLD Report Recommends the Use of Long‑Acting Bronchodilators for COPD Maintenance Therapy

According to GOLD, COPD patients in groups A, B, C, and D may benefit from a long-acting bronchodilator1

  1. Spirometrically confirmed diagnosis

    Post-bronchodilator FEV1/FVC <0.7

  2. Assessment of airflow limitation

    FEV1 (% predicted)
    GOLD 1 ≥80
    GOLD 2 50-79
    GOLD 3 30-49
    GOLD 4 <30
  3. Assessment of symptoms/Risk of exacerbations

    Exacerbation history  
    ≥2 or ≥1 leading to hospital admission
    C
    D
    0 or 1 (not leading to hospital admission)
    A
    B
      mMRC 0-1 mMRC ≥2
      Symptoms
     

Who is GOLD

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) was launched in 1997 in collaboration with the National Heart, Lung, and Blood Institute, the National Institutes of Health, USA, and the World Health Organization. The 2018 GOLD Report was shaped by committees made up of leading experts from around the world. Working with health care professionals and public health officials, GOLD seeks to raise awareness and improve prevention and treatment of COPD.


Assess risk of COPD exacerbations according to GOLD classification and exacerbation history1

Highlighted boxes and arrows indicate preferred treatment pathways

C

LAMA + LABA
LABA + ICS

Further Exacerbation(s)

LAMA

D

Consider roflumilastif FEV1 <50% pred. and patient has chronic bronchitis
Consider macrolide (in former smokers)

Further Exacerbation(s)

LAMA + LABA + ICS

Persistent symptoms/further exacerbation(s)

Further exacerbation(s)

LAMA
LAMA + LABA
LABA + ICS

A

Continue, stop or try alternative class of bronchodilator

Evaluate effect

A bronchodilator

B

LAMA + LABA

Persistent symptoms

A long-acting bronchodilator (LABA or LAMA)

© 2018 Global Strategy for Diagnosis, Management, and Prevention of COPD. All rights reserved. Use is by express license from the owner.

Preferred treatment, according to GOLD =

In patients with a major discrepancy between the perceived level of symptoms and severity of airflow limitation, further evaluation is warranted.

For Group A, the maintenance bronchodilator can be short-acting or long-acting. A maintenance bronchodilator does not replace rescue medication.

GOLD does not endorse any specific treatments.

Determination of an appropriate long-acting bronchodilator is based on symptom control.



Impact and Treatment of COPD in Long-Term Care

COPD Incidence and Impact in LTC

COPD is a top-5 cause of avoidable hospital admissions1* Readmission

Approximately 1 in 5 long-term care residents has COPD2 Long-term Care residents

No Sunovion product has been indicated or shown to reduce hospitalizations in prospective, randomized, placebo-controlled studies.

Treatment of COPD in the LTC setting often does not align with the Clinical Practice Guidelines of AMDA–The Society for Post-Acute and Long-Term Care Medicine (AMDA) or recommendations from the Global Initiative for Chronic Obstructive Lung Disease (GOLD).2,3 View Clinical Guidelines

COPD is a major cause of hospitalizations in LTC residents

  • Approximately 1 in 5 hospitalized residents age 75 years and older discharged to a skilled nursing facility (SNF) is readmitted within 30 days4

In a study of 3,037 LTC residents with COPD5

  • 43% were admitted to the hospital at least once
  • 90% experienced at least 1 emergency department visit

COPD costs are substantial and on the rise

  • National US surveys estimate 70% of COPD expenditures are related to hospitalizations and ED visits5
  • COPD costs are projected to increase from $32 billion in 2010 to $49 billion in 20206

Long Term Care PDF

Read more about COPD in the long-term care setting in Annals of Long-Term Care.

Download the PDF

COPD is undertreated in the LTC setting

SABA monotherapy is overused as maintenance therapy for COPD2

  • The GOLD Report recommends using long-acting bronchodilators, including long-acting beta2-agonists, as a standard of care for COPD maintenance7

GOLD does not endorse specific treatments.

More than two-thirds of patients use their inhalation devices incorrectly7

  • This can result in decreased delivery of medication and, over time, may reduce COPD symptom control8


Importance of Maintenance Therapy

Long-acting bronchodilators are underutilized in LTC settings

In a study of 27,106 LTC residents with COPD

  • 17% received no respiratory treatments for COPD2

In a study of Medicare patients with COPD

  • 69% of those with more severe COPD and multiple comorbidities did not receive a long-acting COPD maintenance medication9

In another study

  • 60% of LTC residents with COPD did not receive a long-acting COPD maintenance therapy2

LTC residents with COPD often have more advanced COPD. For these patients, AMDA recommends maintenance therapy with long-acting bronchodilators, such as a LABA or LAMA alone or in combination.8

Maintenance therapy

AMDA recommends maintenance therapy in LTC.

Read a summary about the guidelines

AMDA does not endorse any specific treatments.

If COPD symptoms persist despite appropriate treatment, first check that the patient is using the inhalation device correctly before switching or adding additional medications.7,8

Most residents in LTC facilities should be on long-acting bronchodilators for maintenance treatment, such as a LABA or a LAMA, either alone or in combination, with short-acting bronchodilators used as needed for rescue.8

The importance of choosing an appropriate inhalation device for each individual patient cannot be overemphasized.7,8



For fast, convenient access to resources for the brands you prescribe most, Sunovion ProFile is ready to assist you—on any device, at any time.

Get quick access to samples, savings cards,
and other resources for your patients and practice.

Register Now

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR ARCAPTA NEOHALER, SEEBRI NEOHALER, UTIBRON NEOHALER, LONHALA MAGNAIR AND BROVANA

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR ARCAPTA NEOHALER, SEEBRI NEOHALER, AND UTIBRON NEOHALER

IMPORTANT SAFETY INFORMATION

WARNING: ASTHMA-RELATED DEATH

Long-acting beta2-adrenergic agonists (LABAs) increase the risk of asthma-related death. Data from a large placebo-controlled US study that compared the safety of another LABA (salmeterol) or placebo added to usual asthma therapy showed an increase in asthma-related deaths in patients receiving salmeterol. This finding with salmeterol is considered a class effect of all LABAs, including indacaterol, the active ingredient in ARCAPTA NEOHALER, and one of the active ingredients in UTIBRON NEOHALER.

The safety and efficacy of ARCAPTA NEOHALER or of UTIBRON NEOHALER in patients with asthma have not been established. ARCAPTA NEOHALER and UTIBRON NEOHALER are not indicated for the treatment of asthma.

 

All LABAs, including indacaterol, are contraindicated in patients with asthma without the use of a long-term asthma-control medication; ARCAPTA NEOHALER is also contraindicated in patients with a history of hypersensitivity to indacaterol or to any of the ingredients, and UTIBRON NEOHALER is contraindicated in patients with a history of hypersensitivity to indacaterol, glycopyrrolate, or to any of the ingredients. SEEBRI NEOHALER is contraindicated in patients with a hypersensitivity to glycopyrrolate or to any of the ingredients.

ARCAPTA NEOHALER, SEEBRI NEOHALER, or UTIBRON NEOHALER should not be initiated in patients with acutely deteriorating or potentially life-threatening episodes of COPD, or used as rescue therapy for acute episodes of bronchospasm. Acute symptoms should be treated with an inhaled short-acting beta2-agonist.

ARCAPTA NEOHALER or UTIBRON NEOHALER should not be used more often, at higher doses than recommended, or in conjunction with other medicines containing LABAs as an overdose may result. Patients who have been taking inhaled short-acting beta2-agonists on a regular basis should be instructed to discontinue their regular use and to use them only for symptomatic relief of acute respiratory symptoms. Clinically significant cardiovascular effects and fatalities have been reported in association with excessive use of inhaled sympathomimetic drugs. Patients using ARCAPTA NEOHALER or UTIBRON NEOHALER should not use another medicine containing a LABA for any reason.

Immediate hypersensitivity reactions have been reported with ARCAPTA NEOHALER, SEEBRI NEOHALER, and UTIBRON NEOHALER. If signs occur, discontinue immediately and institute alternative therapy. ARCAPTA NEOHALER, SEEBRI NEOHALER, and UTIBRON NEOHALER should be used with caution in patients with severe hypersensitivity to milk proteins.

As with other inhaled medicines, ARCAPTA NEOHALER, SEEBRI NEOHALER, and UTIBRON NEOHALER can produce paradoxical bronchospasm that may be life threatening. If paradoxical bronchospasm occurs following dosing with ARCAPTA NEOHALER, SEEBRI NEOHALER, or UTIBRON NEOHALER, it should be treated immediately with an inhaled, short-acting bronchodilator; ARCAPTA NEOHALER, SEEBRI NEOHALER, or UTIBRON NEOHALER should be discontinued immediately and alternative therapy instituted.

Indacaterol, like other beta2-adrenergic agonists, can produce a clinically significant cardiovascular effect in some patients as measured by increases in pulse rate, systolic or diastolic blood pressure, or symptoms. ARCAPTA NEOHALER and UTIBRON NEOHALER should be used with caution in patients with cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmias, and hypertension. beta2-adrenergic agonists may produce significant hypokalemia in some patients.

As with other beta2-adrenergic agonists, indacaterol should be administered with extreme caution in patients being treated with monoamine oxidase inhibitors, tricyclic antidepressants, or other drugs known to prolong the QTc interval because these agents may potentiate the action of adrenergic agonists on the cardiovascular system.

As with other beta2-adrenergic agonists, ARCAPTA NEOHALER and UTIBRON NEOHALER should be used with caution in patients treated with additional adrenergic drugs, non-potassium-sparing diuretics, and beta-blockers.

ARCAPTA NEOHALER and UTIBRON NEOHALER, like all medicines containing sympathomimetic amines, should be used with caution in patients with convulsive disorders, thyrotoxicosis, diabetes mellitus, ketoacidosis, and in patients who are unusually responsive to sympathomimetic amines. SEEBRI NEOHALER and UTIBRON NEOHALER should be used with caution in patients with narrow-angle glaucoma and in patients with urinary retention. Prescribers and patients should be alert for signs and symptoms of acute narrow-angle glaucoma (e.g., eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema) and of urinary retention (e.g., difficulty passing urine, painful urination), especially in patients with prostatic hyperplasia or bladder-neck obstruction. Patients should be instructed to consult a physician immediately should any signs or symptoms develop.

In 6 clinical trials, 48% of ARCAPTA NEOHALER patients reported adverse reactions compared with 43% of placebo patients. The most common adverse events reported in ≥2% of patients taking ARCAPTA NEOHALER, and occurring more frequently than in patients taking placebo, were cough (6.5% vs 4.5%), nasopharyngitis (5.3% vs 2.7%), headache (5.1% vs 2.5%), nausea (2.4% vs 0.9%), and oropharyngeal pain (2.2% vs 0.7%). The most common serious adverse reactions of ARCAPTA NEOHALER patients were COPD exacerbation, pneumonia, angina pectoris, and atrial fibrillation, which occurred at similar rates across treatment groups.

The most common adverse events reported in ≥1% of patients taking SEEBRI NEOHALER, and occurring more frequently than in patients taking placebo, were upper respiratory tract infection (3.4% vs 2.3%), nasopharyngitis (2.1% vs 1.9%), oropharyngeal pain (1.8% vs 1.2%), urinary tract infection (1.4% vs 1.3%), and sinusitis (1.4% vs 0.7%).

The most common adverse events reported in ≥1% of patients taking UTIBRON NEOHALER, and occurring more frequently than in patients taking placebo, were nasopharyngitis (4.1% vs 1.8%), hypertension (2.0% vs 1.4%), back pain (1.8% vs 0.6%), and oropharyngeal pain (1.6% vs 1.2%).

ARCAPTA capsules, SEEBRI capsules, and UTIBRON capsules must not be swallowed as the intended effects on the lungs will not be obtained. ARCAPTA capsules, SEEBRI capsules, and UTIBRON capsules are only for oral inhalation and should only be used with the NEOHALER device.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

For additional information, please see full Prescribing Information, including BOXED WARNINGS and Medication Guides, for ARCAPTA NEOHALER and UTIBRON NEOHALER, and Patient Information for SEEBRI NEOHALER at www.SunovionProFile.com/ARCAPTA, www.SunovionProFile.com/UTIBRON, and www.SunovionProFile.com/SEEBRI.

INDICATIONS

ARCAPTA® NEOHALER® (indacaterol) is a long-acting beta2-adrenergic agonist (LABA), SEEBRI® NEOHALER® (glycopyrrolate) is an anticholinergic, and UTIBRON® NEOHALER® (indacaterol and glycopyrrolate) is a combination of indacaterol and glycopyrrolate; all are indicated for the long-term, maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.

Important limitations: ARCAPTA NEOHALER and UTIBRON NEOHALER are not indicated to treat acute deteriorations of COPD and are not indicated to treat asthma.

 

IMPORTANT SAFETY INFORMATION AND INDICATION FOR LONHALA MAGNAIR

IMPORTANT SAFETY INFORMATION

LONHALA MAGNAIR is contraindicated in patients with a hypersensitivity to glycopyrrolate or to any of the ingredients.

LONHALA MAGNAIR should not be initiated in patients with acutely deteriorating or potentially life-threatening episodes of COPD or used as rescue therapy for acute episodes of bronchospasm. Acute symptoms should be treated with an inhaled short-acting beta2-agonist.

As with other inhaled medicines, LONHALA MAGNAIR can produce paradoxical bronchospasm that may be life-threatening. If paradoxical bronchospasm occurs following dosing with LONHALA MAGNAIR, it should be treated immediately with an inhaled, short-acting bronchodilator; LONHALA MAGNAIR should be discontinued immediately and alternative therapy instituted.

Immediate hypersensitivity reactions have been reported with LONHALA MAGNAIR. If signs occur, discontinue LONHALA MAGNAIR immediately and institute alternative therapy.

LONHALA MAGNAIR should be used with caution in patients with narrow-angle glaucoma and in patients with urinary retention. Prescribers and patients should be alert for signs and symptoms of acute narrow-angle glaucoma (e.g., eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema) and of urinary retention (e.g., difficulty passing urine, painful urination), especially in patients with prostatic hyperplasia or bladder-neck obstruction. Patients should be instructed to consult a physician immediately should any of these signs or symptoms develop.

The most common adverse events reported in ≥2% of patients taking LONHALA MAGNAIR, and occurring more frequently than in patients taking placebo, were dyspnea (4.9% vs 3.0%) and urinary tract infection (2.1% vs 1.4%).

LONHALA solution is for oral inhalation only and should not be injected or swallowed. LONHALA vials should only be administered with MAGNAIR.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

For additional information, please see full Prescribing Information and Patient Information for LONHALA MAGNAIR at www.SunovionProFile.com/lonhala-magnair.

INDICATION

LONHALA® MAGNAIR® (glycopyrrolate) is an anticholinergic indicated for the long-term maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.

 

IMPORTANT SAFETY INFORMATION AND INDICATION FOR BROVANA

IMPORTANT SAFETY INFORMATION

WARNING: ASTHMA-RELATED DEATH

Long-acting beta2-adrenergic agonists (LABAs) increase the risk of asthma-related death. Data from a large placebo-controlled US study that compared the safety of another LABA (salmeterol) or placebo added to usual asthma therapy showed an increase in asthma-related deaths in patients receiving salmeterol. This finding with salmeterol is considered a class effect of LABAs, including arformoterol, the active ingredient in BROVANA.

The safety and efficacy of BROVANA in patients with asthma have not been established. BROVANA is not indicated for the treatment of asthma.

 

All LABAs, including BROVANA, are contraindicated in patients with asthma without use of a long-term asthma control medication; BROVANA is also contraindicated in patients with a history of hypersensitivity to arformoterol, racemic formoterol or to any of the ingredients. 

BROVANA should not be initiated in patients with acutely deteriorating COPD or potentially life-threatening episodes of COPD, or used as rescue therapy for acute episodes of bronchospasm. Acute symptoms should be treated with an inhaled short-acting beta2-agonist.

BROVANA should not be used more often, at higher doses than recommended, or in conjunction with other medications containing LABAs as an overdose may result. Patients who have been taking inhaled short-acting beta2-agonists on a regular basis should be instructed to discontinue their regular use and to use them only for symptomatic relief for acute respiratory symptoms. Clinically significant cardiovascular effects and fatalities have been reported in association with excessive use of inhaled sympathomimetic drugs. Patients using BROVANA should not use another medicine containing a LABA for any reason.

Immediate hypersensitivity reactions may occur with BROVANA. If signs occur, discontinue immediately and institute alternative therapy.

As with other inhaled beta2-agonists, BROVANA can produce paradoxical bronchospasm that may be life-threatening. If paradoxical bronchospasm occurs, BROVANA should be discontinued immediately and alternative therapy instituted.

BROVANA, like other beta2-agonists, can produce a clinically significant cardiovascular effect in some patients as measured by increases in pulse rate, systolic or diastolic blood pressure, and/or symptoms. BROVANA should be used with caution in patients with cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmias, and hypertension. Beta2-adrenergic agonists may produce significant hypokalemia in some patients.

As with other beta2-agonists, BROVANA, should be administered with extreme caution to patients being treated with monoamine oxidase inhibitors, tricyclic antidepressants, or drugs known to prolong the QTc interval because these agents may potentiate the action of adrenergic agonists on the cardiovascular system.

As with other beta2-agonists, BROVANA should be used with caution in patients treated with additional adrenergic drugs, non-potassium-sparing diuretics, and beta-blockers.

BROVANA, like all medicines containing sympathomimetic amines, should be used with caution in patients with convulsive disorders, thyrotoxicosis, diabetes mellitus, ketoacidosis, and in patients who are unusually responsive to sympathomimetic amines.

Overall efficacy of BROVANA was maintained throughout the 12-week trial duration. Some tolerance to the bronchodilator effect of BROVANA was observed after 6 weeks of dosing (at the end of the dosing interval), although the FEV1 improvement remained statistically significant. This was not accompanied by other clinical manifestations of tolerance.

The five most common adverse events reported with frequency ≥2% in patients taking BROVANA, and occurring more frequently than in patients taking placebo, were pain (8% vs 5%), chest pain (7% vs 6%), back pain (6% vs 2%), diarrhea (6% vs 4%), and sinusitis (5% vs 4%).

BROVANA should not be swallowed as the intended effects on the lungs will not be obtained.  BROVANA is only for oral inhalation via a standard jet nebulizer connected to an air compressor.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

For additional information, please see the full Prescribing Information including BOXED WARNING, and Medication Guide for BROVANA (arformoterol tartrate) Inhalation Solution, at www.sunovionprofile.com/brovana.

INDICATION
BROVANA® (arformoterol tartrate) Inhalation Solution is a long-acting beta2-adrenergic agonist (LABA) indicated for the long-term, twice-daily (morning and evening) maintenance treatment of bronchoconstriction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema. BROVANA is for use by nebulization only.

Important limitations: BROVANA is not indicated to treat acute deteriorations of COPD and is not indicated to treat asthma.