Comparison of indacaterol with tiotropium or twice-daily long-acting β -agonists for stable COPD: a systematic review.

Abstract

BACKGROUND:

Bronchodilators are central to the symptomatic management of patients with COPD.Previous data have shown that inhaled indacaterol improved numerous clinical outcomes over placebo.

METHODS:

This systematic review explored the efficacy and safety of indacaterol in comparison with tiotropium or bid long-acting β 2 -agonists (TD-LABAs) for treatment of moderate to severe COPD. Randomized controlled trials were identified after a search of different databases of published and unpublished trials.

RESULTS:

Five trials (5,920 participants) were included. Compared with tiotropium, indacaterol showed statistically and clinically significant reductions in the use of rescue medication and dyspnea(43% greater likelihood of achieving a minimal clinically important difference [MCID] in the transitional dyspnea index [TDI]; number needed to treat for benefit [NNTB] 5 10). Additionally,the MCID in health status was more likely to be achieved with indacaterol than with tiotropium (OR = 1.43; 95% CI, 1.22–1.68; P = .00001; [NNTB ]= 10). Trough FEV 1 was significantly higher at the end of treatment with indacaterol than with TD-LABAs (80 mL, P = .00001). Similarly, indacaterol signifi cantly improved dyspnea (61% greater likelihood of achieving an MCID in TDI, P = .008) and health status (21% greater likelihood of achieving an MCID in St. George’s Respiratory Questionnaire, P 5 .04) than TD-LABA. Indacaterol showed similar levels of safety and tolerability to both comparators.

CONCLUSIONS:

Available evidence suggests that indacaterol may prove useful as an alternative to tiotropium or TD-LABA due to its effects on health status, dyspnea, and pulmonary function.

• Authors: Gustavo J Rodrigo, Hugo Neffen
• Journal: Chest (Chest) Vol. 142 Issue 5 Pg. 1104-1110 (Nov 2012) ISSN: 1931-3543 [Electronic] United States
• PMID: 22383666 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Review, Systematic Review)

Chemical References

• Adrenergic beta-Agonists
• Bronchodilator Agents
• Indans
• Quinolones
• Scopolamine Derivatives
• indacaterol
• Tiotropium Bromide

Topics

• Adrenergic beta-Agonists (administration & dosage)
• Bronchodilator Agents (administration & dosage)
• Evidence-Based Medicine
• Humans
• Indans (administration & dosage)
• Pulmonary Disease, Chronic Obstructive (drug therapy, physiopathology)
• Quinolones (administration & dosage)
• Randomized Controlled Trials as Topic
• Respiratory Function Tests
• Scopolamine Derivatives (administration & dosage)
• Tiotropium Bromide