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Chest. 2012 Nov;142(5):1104-1110. doi: 10.1378/chest.11-2252.

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

Author information

1
Departamento de Emergencia, Hospital Central de las Fuerzas Armadas, Montevideo, Uruguay. Electronic address: gustavo.javier.rodrigo@gmail.com.
2
Unidad de Medicina Respiratoria, Hospital de Niños "O. Allassia" Santa Fe, Argentina.

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 Randomized controlled trials were identified after a search of different databases of published and unpublished trials.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.

PMID:
22383666
DOI:
10.1378/chest.11-2252
[Indexed for MEDLINE]

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