Brimica Genuair 340/12 is a medicine containing the active ingredient(s) aclidinium + formoterol (eformoterol). Brimica Genuair is indicated as a maintenance bronchodilator treatment for airflow obstruction and relief of symptoms in adult patients with chronic obstructive pulmonary disease (COPD).
What is Brimica Genuair and what is it used for?
- Brimica Genuair is a medicine used to relieve the symptoms of chronic obstructive pulmonary disease (COPD) in adults. COPD is a long-term disease in which the airways and air sacs inside the lungs become damaged or blocked, leading to difficulty breathing. Brimica Genuair is used for maintenance (regular) treatment.
- Brimica Genuair contains two active substances: aclidinium bromide and formoterol fumarate dihydrate.
How is Brimica Genuair used?
- Brimica Genuair is available as an inhalation powder 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 one inhalation twice a day.
How does Brimica Genuair work?
- The two active substances in Brimica Genuair, aclinidium bromide and formoterol fumarate dihydrate, work 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 widens the airways by blocking some receptors in muscle cells in the lungs called muscarinic (also known as cholinergic) receptors, which control the contraction of muscles. When aclidinium bromide is inhaled, it causes the muscles of the airways to relax, helping to keep the airways 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 found in the muscles of the airways. When it attaches to these receptors, it causes the muscles to relax, which keeps the airways open and helps with the patient’s breathing.
- Long-acting muscarinic antagonists and long-acting beta-2 agonists are commonly combined in the management of COPD. Aclidinium bromide has been authorised in the EU as Bretaris Genuair and Eklira Genuair since July 2012; formoterol has been marketed in the EU since the 1990s.
What benefits of Brimica Genuair have been shown in studies?
- Brimica Genuair has been studied in 2 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 patients’ forced expiratory volumes (FEV1, the maximum volume of air a person can breathe out in one second) after six months.
- Results showed that, after six months of treatment, the increase in FEV1 (measured one hour after an inhalation) was 293 milliliters (ml) more with Brimica Genuair than with placebo and 118 ml more with Brimica Genuair than with aclidinium alone. However the improvement over formoterol alone was small and not considered clinically significant: FEV1 measured in the morning before the inhalation was 68 ml more with Brimica Genuair than with formoterol alone. Brimica Genuair was also shown to increase the percentage of patients who had an improvement in breathlessness compared with placebo.
What are the risks associated with Brimica Genuair?
- Side effects with Brimica Genuair are similar to those with the individual components. The most common side effects (seen in around 7 patients in 100) are nasopharyngitis (inflammation of the nose and throat) and headache.
Why is Brimica Genuair 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 was shown to significantly improve lung function in patients with COPD compared with placebo, although the improvement observed when Brimica Genuair was compared with one of the components on its own, formoterol, was small.
- Regarding safety, the number of side effects reported with Brimica Genuair was low and did not raise any major safety concern. In addition, the safety profile of the two components is well known, and there is no evidence that the combination is worse than the individual components.
What measures are being taken to ensure the safe and effective use of Brimica Genuair?
- 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.
- In addition, 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 can be found in the summary of the risk management plan.