A Study on the Use of Nebulized Glycopyrronium in Hospitalized Patients With Exacerbations of Obstructive Airway Disease

Introduction Acute exacerbations of obstructive airway diseases (OAD) are commonly encountered respiratory conditions that often require hospitalization and intensive bronchodilator therapy. While short-acting β2-agonists (SABAs) and muscarinic antagonists (SAMAs) are commonly used, nebulized glycopyrronium, a long-acting muscarinic antagonist (LAMA), may offer better outcomes. Methods This was a multicenter, retrospective study done across 278 sites to assess the overall utilization and effectiveness of nebulized glycopyrronium in managing exacerbations in hospitalized patients with obstructive airway disease in a real-world Indian setting. Medical records of hospitalized patients were analyzed, where nebulized glycopyrronium was used in the management of exacerbation for information regarding utilization and effectiveness. Outcomes included the length of intensive care unit (ICU) stay, ward stay, oxygen requirement, ventilation support, adverse events, and mortality. Results A total of 2,780 medical records were analyzed across multiple tertiary care centers. The analyzed population had a mean age of 59.56 years (±9.72). Nebulized glycopyrronium was administered as combination therapy in 1,306 (48.44%) patients and as monotherapy in 1,390 (51.56%) patients. The majority of the patients (2,336, 90.61%) received twice-a-day (BID) dosing. The mean duration of glycopyrronium therapy was 13.45 days. A total of 68 adverse events were reported, most of which were mild and self-limiting. Dry mouth was the most frequent complaint (13, 0.46%), followed by dizziness and transient headache. Mortality was observed in 42 (1.52%) of the treated population, with no direct attribution to glycopyrronium therapy. Conclusion Nebulized glycopyrronium is an effective therapy in hospitalized patients with obstructive airway disease, offering faster recovery and reduced oxygen dependency.