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**Ensifentrine + glycopyrrolate** is a fixed-dose combination under investigation for the treatment of chronic obstructive pulmonary disease (COPD). Ensifentrine is a dual inhibitor of phosphodiesterase 3 (PDE3) and phosphodiesterase 4 (PDE4), which increases intracellular cAMP and/or cGMP, resulting in bronchodilation, anti-inflammatory effects, and improved mucociliary clearance. Glycopyrrolate is a long-acting muscarinic receptor antagonist that produces bronchodilation by inhibiting acetylcholine-induced bronchial smooth muscle contraction. The combination aims to maximize bronchodilation and symptom relief by targeting both beta-adrenergic (via cAMP) and muscarinic pathways with non-steroidal anti-inflammatory effects. The product is being developed for twice-daily oral inhalation via nebulizer in adults with COPD and is currently in Phase IIb clinical trials. Combination studies have demonstrated synergistic bronchodilation and improvement in lung function, symptoms, and exacerbation risk compared to monotherapy or placebo[1][3][4][5][6].
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