Why prescribe a LAMA for COPD at diagnosis?
A LAMA, like SPIRIVA RESPIMAT 2.5mcg, provides the long-acting control a SABA alone cannot1,2
Start a LAMA, like SPIRIVA RESPIMAT, for your patients with mild COPD1,2
Tiotropium contributes to ameliorating the annual decline of FEV14-6*
Initiating tiotropium early contributes to improving lung function3,4
SPIRIVA RESPIMAT 2.5mcg is the only LAMA indicated to reduce COPD exacerbations1
From day 30 through month 24, annual FEV₁ decline in patients taking tiotropium 18 mcg† was 29 mL per year vs 51 mL for placebo—a significant difference of 22 mL per year; (95% CI, 6 to 37); P=0.006.
While only smoking cessation is proven to slow the progression of COPD, data suggest that starting tiotropium early is associated with benefits in disease progression
CI, confidence interval; FEV1, forced expiratory volume in one second; LAMA, long-acting muscarinic antagonist; SABA, short-acting beta2-agonist.
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*
After bronchodilator use in patients with GOLD stage 1 or 2 COPD.
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†
This study was conducted in an ex-US population using SPIRIVA® HANDIHALER® (tiotropium bromide inhalation powder).
FAQs
Expand allPatients with mild COPD who could potentially benefit from maintenance treatment may exhibit the following characteristics:
- Adult patients, mid-40s to early 50s
- Recently diagnosed, maintenance treatment-naïve patient
- Exhibiting signs of early COPD, such as dyspnea with exertion, wheezing or coughing, chest tightness, increased sputum production, respiratory infections
Evidence suggests that a greater degree of lung function decline may occur in early stages of COPD compared with later stages.7,8 Therefore, early diagnosis and intervention may be critical to achieving improved outcomes in patients with COPD.9
Identify patients with mild COPD who can benefit from maintenance treatment
- Adult patients, mid-40s to early 50s
- Recently diagnosed, maintenance treatment–naive patient
- Exhibiting signs of early COPD, such as dyspnea with exertion, wheezing or coughing, chest tightness, increased sputum production, respiratory infections
Learn how SPIRIVA RESPIMAT helped Amanda take control of her COPD
Hi, I'm Amanda. I live in Florida. I live with COPD. My journey began after three hospitalizations. I was extremely scared, nervous, confused. I knew absolutely nothing about COPD. I knew no one that had COPD. I spent about two days trying to process it all; wrap my head around everything. And I realized that I myself had to do something, and I refused to be homebound. I had to kind of pick myself up and realize that I've got to move forward. And I started to read what the doctors had ordered me to do when I go in and picking up everything that I needed to get to begin this new journey with COPD. I had to learn how to navigate a new normal in my life. And I've had the ability to go out here and live the life that I still enjoy everything that I did before. I can walk my entire village, which I do every morning, and even on days that I don't feel 100%, I will still make myself go sit outside and breathe the air and as I take a deep breath and I take it all in, taking time out just for the moment. But I was a woman that went 100 miles an hour my whole entire life, and I missed out on a lot of that. I would encourage anyone who’s been newly diagnosed with COPD to reach out to their physicians and ask them about SPIRIVA RESPIMAT. And I would also encourage them to educate themselves on the disease itself. COPD affects over 16,000,000 Americans every year, and it makes me terribly sad. I live with COPD, and I'm here to help people understand that they also can live with COPD. SPIRIVA RESPIMAT is a maintenance inhaler and it helps manage and control your COPD. If you're experiencing shortness of breath, wheezing, or chronic cough, talk to your doctor about COPD and how you can breathe easier. I breathe easier today because I worked out a treatment plan with my doctor that works best for me. SPIRIVA RESPIMAT works great for me. It may not work for you. Talk to your doctor and find out what works best for you. I don't let COPD define me.
FAQs
Expand allSoft mist delivery helps patients inhale their medicine. Just a slow deep breath is required; there is no need to inhale sharply.1*
*As with all inhaled drugs, the actual amount of drug delivered to the lung may depend on patient factors, such as the coordination between the actuation of the inhaler an inspiration through the delivery system. The duration of inspiration should be at least as long as the spray duration (1.5 seconds).
A retrospective, non-interventional database study compared COPD-related exacerbations and 30-day all-cause readmissions following COPD-related hospitalization in patients who initiated LAMA treatment with a soft mist inhaler (SMI) or dry powder inhaler (SPI).3 For inclusion, patients were required to be Medicare Advantage with Part D program beneficiaries aged ≥40 years, to have a COPD diagnosis code on a medical claim during the identification period, and to have continuous enrollment with medical and pharmacy coverage for ≥12 months before and ≥30 days after the index date.3
Using de-identified administrative claims data from September 1, 2013 through July 31, 2018, a total of 28,240 patients were included in the study (SMI cohort: n=5360; DPI cohort: n=22,880).3
- The SMI cohort included only users of tiotropium bromide as index LAMA3
- Among patients in the DPI cohort, 86% received tiotropium bromide (n=19,644), 13% received umeclidinium bromide (n=2893), 1% received aclidinium bromide (n=337), and <1% received glycopyrrolate (n=6) as their index LAMA3
The weighted mean number of COPD-related exacerbations was significantly lower among the SMI cohort compared with the DPI cohort (0.054 ± 0.082 PPPM versus 0.059 ± 0.088 PPPM, P<0.001). Additionally, hospital readmissions within were less likely to occur after hospitalization among SMP initiators compared with DPI initiators (12.7% vs 20.1%, P<0.001).3
SPIRIVA RESPIMAT, 2.5mcg, is indicated for the long-term, once-daily, maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema, and for reducing COPD exacerbations.
SPIRIVA RESPIMAT, 1.25mcg, is a bronchodilator indicated for the long-term, once-daily, maintenance treatment of asthma in patients 6 years of age and older.
SPIRIVA RESPIMAT is not indicated for relief of acute bronchospasm.
SPIRIVA® RESPIMAT® (tiotropium bromide) Inhalation Spray is contraindicated in patients with a hypersensitivity to tiotropium, ipratropium, or any component of this product. Immediate hypersensitivity reactions, including angioedema (including swelling of the lips, tongue, or throat), itching, or rash have been reported.
SPIRIVA RESPIMAT is intended as a once-daily maintenance treatment for COPD and asthma, and should not be used for the relief of acute symptoms, i.e., as rescue therapy for the treatment of acute episodes of bronchospasm. In the event of an attack, a rapid-acting beta2-agonist should be used.
Immediate hypersensitivity reactions, including urticaria, angioedema (including swelling of the lips, tongue, or throat), rash, bronchospasm, anaphylaxis, or itching may occur after administration of SPIRIVA RESPIMAT. If such a reaction occurs, discontinue SPIRIVA RESPIMAT at once and consider alternative treatments. Given the similar structural formula of atropine to tiotropium, patients with a history of hypersensitivity reactions to atropine or its derivatives should be closely monitored for similar hypersensitivity reactions to SPIRIVA RESPIMAT.
Inhaled medicines, including SPIRIVA RESPIMAT, may cause paradoxical bronchospasm. If this occurs, it should be treated with an inhaled short-acting beta2-agonist, such as albuterol. Treatment with SPIRIVA RESPIMAT should be stopped and other treatments considered.
SPIRIVA RESPIMAT should be used with caution in patients with narrow-angle glaucoma. 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). Instruct patients to consult a physician immediately should any of these signs or symptoms develop.
Since dizziness and blurred vision may occur with the use of SPIRIVA RESPIMAT, caution patients about engaging in activities such as driving a vehicle, or operating appliances or machinery.
SPIRIVA RESPIMAT should be used with caution in patients with urinary retention. Prescribers and patients should be alert for signs and symptoms of urinary retention (e.g., difficulty passing urine, painful urination), especially in patients with prostatic hyperplasia or bladder-neck obstruction. Instruct patients to consult a physician immediately should any of these signs or symptoms develop.
Patients with moderate to severe renal impairment (creatinine clearance of <60 mL/min) treated with SPIRIVA RESPIMAT should be monitored closely for anticholinergic side effects.
The most common adverse reactions >3% incidence and higher than placebo with SPIRIVA RESPIMAT (placebo) in COPD trials were pharyngitis 11.5% (10.1%), cough 5.8% (5.5%), dry mouth 4.1% (1.6%), and sinusitis 3.1% (2.7%).
The most common adverse reactions >2% incidence and higher than placebo with SPIRIVA RESPIMAT (placebo) in asthma trials in adults were pharyngitis 15.9% (12.4%), headache 3.8% (2.7%), bronchitis 3.3% (1.4%), and sinusitis 2.7% (1.4%). The adverse reaction profile for adolescent and pediatric patients was comparable to that observed in adult patients with asthma.
SPIRIVA RESPIMAT may interact additively with concomitantly used anticholinergic medications. Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs.
Inform patients not to spray SPIRIVA RESPIMAT into the eyes as this may cause blurring of vision and pupil dilation.
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.
CL-SVR-100065 2.15.2017
Please see full Prescribing Information, including Instructions for Use, for SPIRIVA RESPIMAT.
Reference
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SPIRIVA RESPIMAT [prescribing information]. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc; January 2025