Novel long-acting antimuscarinic agents undergoing development
| Drug | Advantages | Latest developments | Company working on this strategy |
| Aclidinium bromide | Apparently, it displays a faster onset but shorter duration of activity than does tiotropium. The rapid hydrolysis of aclidinium bromide in human plasma to inactive metabolites is an advantage over tiotropium as its degradation is negligible, and may account for a favourable cardiovascular safety profile. The partially disappointing efficacy results of the ACCLAIM/COPD trials question the possibility that aclidinium is at least as effective as tiotropium. | Phase III | Almirall Prodesfarma, Barcelona, Spain |
| Glycopyrronium bromide | It shows low systemic absorption. It exhibits a rapid onset of action. Overall, improvements in lung function with glycopyrronium bromide appear comparable with those of tiotropium. | Phase III | Novartis, Basle, Switzerland |
| GSK-573719 | Its long duration of action when administered via inhalation in animal models supports the potential for use as a once-daily bronchodilator for COPD. Clinical data have not been disclosed. | Phase II | GlaxoSmithKline, London, UK |
| QAT-370 | It displays a short plasma half-life but long duration of action similar to that of tiotropium. | Preclinical phase | Novartis, Basle, Switzerland |
| CHF 5407 | It is an antagonist as potent and long-acting as tiotropium on human M3 muscarinic receptors, but significantly short-acting on M2 receptors. Its duration of action is similar to that of tiotropium. | Phase I/II | Chiesi Farmaceutici, Parma, Italy |
| Darotropium bromide | Its long duration of action when administered via inhalation in animal models supports the potential for use as a once-daily bronchodilator for COPD, but no data have yet been presented. | Phase II | GlaxoSmithKline, London, UK |
| TD-4208 | It shows the potential for 24-h bronchodilation in COPD patients. | Phase I/II | Theravance, South San Francisco, CA, USA |
| Dexpirronium | It seems to be similar to formoterol in reducing acetylcholine-induced bronchospasm, at least in animals. | Phase I | Meda Pharma, Bad Homburg, Germany |
ACCLAIM/COPD: AClidinium CLinical Trial Assessing Efficacy and Safety In Moderate to Severe COPD Patients; COPD: chronic obstructive pulmonary disease.