Value through Innovation29 November 2014

Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability throughout the world.

COPD is a progressive respiratory illness characterised by chronic airflow limitation, shortness of breath (or dyspnoea), cough, wheezing and increased sputum (mucus or phlegm) production. These symptoms, in particular breathlessness, can restrict a patient's ability to perform normal daily activities. Smoking is the predominant cause of COPD, accounting for 80-90 % of the risk of developing chronic obstructive pulmonary disease. The disease is increasingly observed in women.

Early diagnosis and treatment of COPD is essential

COPD has a significant physical and emotional impact on those who suffer from the disease. As chronic obstructive pulmonary disease progresses, lung function declines over time and physical activity becomes severely limited, disrupting the patient's ability to lead a full life, interfering with everyday tasks, like participating in family routines and social interactions. Early diagnosis and treatment is important to help patients remain independent, prevent complications and exacerbations, and improve quality of life.

Anticholinergics are a recommended first line recommendation for COPD

Anticholinergics, a traditional core competence of Boehringer Ingelheim, are a first line recommendation for the management of COPD in many guidelines. Their qualities beyond bronchodilatation, i.e. improvement of dyspnoea, exercise tolerance, decreasing COPD exacerbations and improving health related quality of life for patients is the focus of ongoing modern clinical research. These improvements were to some extent already seen with short-acting anticholinergics that are marketed for a longer time, but have become greater with the more recent development of long-acting anticholinergics. In addition to these important benefits the long-acting anticholinergic tiotropium also demonstrated its ability to reduce the risk of death in the 4-year UPLIFT® trial. Further analyses from this long-term trial have shown how the clinical course of the disease can be positively affected when maintenance treatment with tiotropium is initiated as early as recommended in the GOLD Guidelines (Stage II) and have also shown the importance of initiating this treatment in patients previously naïve of maintenance therapy.

The most effective intervention in COPD remains giving up smoking. Consequently smoking cessation should be standard treatment for COPD, accompanied by the usage of bronchodilators.


Spiriva® (tiotropium)

Maintenance treatment of patients with COPD (chronic obstructive pulmonary disease, including chronic bronchitis and emphysema), the maintenance treatment of associated dyspnoea and for prevention of exacerbations.

Atrovent® (ipratropium bromide) 

Indicated as a bronchodilator for maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease, including chronic bronchitis, emphysema and asthma.

Combivent® (ipratropium bromide/salbutamol)

Indicated for the management of bronchospasms associated with reversible obstructive airway diseases in patients who require more than one bronchodilator.

Berodual®Bronchodual® Duovent® (fenoterol/ipratropium bromide)

For prevention and treatment of symptoms in chronic obstructive airway disorders with reversible bronchospasm, such as bronchial asthma, and especially chronic bronchitis, with or without emphysema.

Devices/CFC Transition

The Montreal Protocol and several supplementary legally binding international agreements lay down the gradual elimination of all production and use of ozone depleting substances, particularly chlorofluorocarbons (CFCs) which have been widely used as aerosol propellants. Of particular relevance to Boehringer Ingelheim is the switch from CFC-driven Metered Dose Inhalers to those propelled by the more environmentally-friendly hydrofluoroalkanes (HFAs).

Boehringer Ingelheim has already launched HFA-products for their established bronchodilators Berotec®, Berodual® and Atrovent® in many countries, and has also given a lot of attention to the development of an alternative inhaler device that is propellant-free.

Respimat® Soft Mist™ Inhaler

Respimat® Soft Mist™ Inhaler

The result is the Respimat® Soft Mist™ Inhaler, a highly innovative approach to inhaler technology that is designed to meet patients' needs and is also environmentally friendly. To learn more about Respimat® Soft Mist™ Inhaler we invite you to visit the global Respimat® website.


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