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EMA Approval

Riltrava Aerosphere

R03AL11

formoterol, glycopyrronium bromide and budesonide

Drugs for obstructive airway diseases

Basic Information

R03AL11

formoterol, glycopyrronium bromide and budesonide

Drugs for obstructive airway diseases

Therapeutic indication

Riltrava Aerosphere is indicated as a maintenance treatment in adult patients with moderate to severe chronic obstructive pulmonary disease (COPD) who are not adequately treated by a combination of an inhaled corticosteroid and a long-acting beta2 agonist or combination of a long-acting beta2 agonist and a long-acting muscarinic antagonist (for effects on symptoms control and prevention of exacerbations see section 5.1).

Overview Summary

Riltrava Aerosphere is a medicine used to treat patients with moderate to severe chronic obstructive pulmonary disease (COPD), a long-term disease in which the airways and air sacs in the lungs become damaged or blocked, leading to difficulty breathing.

Riltrava Aerosphere is used for maintenance (regular) treatment in adults whose disease is not controlled well enough with a combination of inhaled medicines consisting of a long-acting beta-2 agonist plus either a corticosteroid or a long-acting muscarinic antagonist.

Riltrava Aerosphere contains the active substances formoterol, glycopyrronium bromide and budesonide.

This medicine is the same as Trixeo Aerosphere, which is already authorised in the EU. The company that makes Trixeo Aerosphere has agreed that its scientific data can be used for Riltrava Aerosphere (‘informed consent’).

Authorisations (1)

EMEA/H/C/005311

AstraZeneca AB,SE-151 85 Sodertalje,Sweden

Authorised

January 6, 2022

Active Substances (4)

Budesonide

formoterol fumarate dihydrate

Glycopyrronium bromide

glycopyrronium bromide

Documents (9)

CHMP summary of opinion for Riltrava Aerosphere

November 12, 2021

CHANGES_SINCE_INITIAL_AUTHORISATION

Riltrava Aerosphere : EPAR - Public Assessment Report

February 4, 2022

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

Riltrava Aerosphere : EPAR - Product Information

February 4, 2022

DRUG_PRODUCT_INFORMATION

Riltrava Aerosphere : EPAR - Risk management plan summary

February 4, 2022

RISK_MANAGEMENT_PLAN_SUMMARY

Riltrava Aerosphere : EPAR - Procedural steps taken and scientific information after authorisation

May 20, 2022

CHANGES_SINCE_INITIAL_AUTHORISATION

Riltrava Aerosphere : EPAR - Medicine Overview

February 4, 2022

OVERVIEW_DOCUMENT

CHMP summary of opinion for Riltrava Aerosphere

November 12, 2021

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

Riltrava Aerosphere : EPAR - All authorised presentations

February 4, 2022

AUTHORISED_PRESENTATIONS

Riltrava Aerosphere : EPAR - Public Assessment Report

February 4, 2022

CHANGES_SINCE_INITIAL_AUTHORISATION

Overview Q&A (7)

Question

How is Riltrava Aerosphere used?

Answer

Riltrava Aerosphere can only be obtained with a prescription. It is available in a portable inhaler device. The recommended dose is two inhalations twice a day (two in the morning and two in the evening). Patients should be shown how to use the inhaler correctly by a doctor or other healthcare professional.

For more information about using Riltrava Aerosphere, see the package leaflet or contact your doctor or pharmacist.

Question

How does Riltrava Aerosphere work?

Answer

Riltrava Aerosphere contains three active substances, which work in different ways to widen the airways and improve breathing in COPD.

Formoterol is a long-acting beta-2 agonist. It attaches to receptors (targets) known as beta-2 receptors 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.

Glycopyrronium bromide is a long-acting muscarinic receptor antagonist. This means that it blocks muscarinic receptors in muscle cells in the airways. Because these receptors help control the contraction of muscles, glycopyrronium causes the muscles of the airways to relax, helping to keep the airways open.

Budesonide belongs to a group of anti-inflammatory medicines known as corticosteroids. It works in a similar way to naturally occurring corticosteroid hormones, reducing the activity of the immune system (the body’s natural defences) by attaching to receptors in various types of immune cell. This leads to a reduction in the release of substances that are involved in the inflammation process, such as histamine, thereby keeping the airways clear and allowing the patient to breathe more easily.

Question

What benefits of Riltrava Aerosphere have been shown in studies?

Answer

Two main studies in over 10,000 patients with moderate to very severe COPD have shown that Riltrava Aerosphere is effective at improving patients’ FEV1 (the maximum volume of air they can breathe out in one second) and at reducing the number of exacerbations (flare-ups) of the disease.

In the first study, patients treated with Riltrava Aerosphere for 24 weeks had FEV1 increases of around 147 ml, compared with 125 ml for patients treated with glycopyrronium/formoterol, and 73 ml and 88 ml for patients treated with two different inhalers containing budesonide/formoterol.

The second study, which lasted one year, showed that patients treated with Riltrava Aerosphere had fewer COPD exacerbations (1.08 per year) than patients treated with with glycopyrronium/formoterol (1.42) or budesonide/formoterol (1.24).

Question

What are the risks associated with Riltrava Aerosphere?

Answer

The most common side effects with Riltrava Aerosphere (which may affect up to 1 in 10 people) are pneumonia (lung infection), headache and urinary tract infection.

For the full list of side effects and restrictions of Riltrava Aerosphere, see the package leaflet.

Question

Why is Riltrava Aerosphere authorised in the EU?

Answer

Riltrava Aerosphere improved lung function in patients with moderate to severe COPD, and reduced disease exacerbations. The safety profile of Riltrava Aerosphere is considered similar to that of medicines containing combinations of a corticosteroid, beta-2 agonist and antimuscarinic. The European Medicines Agency therefore decided that Riltrava Aerosphere’s benefits are greater than its risks and it can be authorised for use in the EU.

Question

What measures are being taken to ensure the safe and effective use of Riltrava Aerosphere?

Answer

Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Riltrava Aerosphere have been included in the summary of product characteristics and the package leaflet.

As for all medicines, data on the use of Riltrava Aerosphere are continuously monitored. Side effects reported with Riltrava Aerosphere are carefully evaluated and any necessary action taken to protect patients.

Question

Other information about Riltrava Aerosphere

Answer

Riltrava Aerosphere received a marketing authorisation valid throughout the EU on 6 January 2022.

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