COMPARISON OF INDACATEROL WITH TIOTROPIUM OR TWICE-DAILY LONG-ACTING BETA-AGONISTS FOR STABLE COPD: A SYSTEMATIC REVIEW.

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COMPARISON OF INDACATEROL WITH TIOTROPIUM OR TWICE-DAILY LONG-ACTING BETA-AGONISTS FOR STABLE COPD: A SYSTEMATIC REVIEW.

Chest. 2012 Mar 1;

Authors: Rodrigo GJ, Neffen H

Abstract
ABSTRACT BACKGROUND:Bronchodilators are central to the symptomatic management of patients with chronic obstructive pulmonary disease (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 twice-daily LABA (TD-LABA), for treatment of moderate-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 Randomized controlled trials were identified after a search of different databases of published and unpublished trials.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 = 10]). Additionally, the MCID in health status was more likely to be achieved with indacaterol than with tiotropium (Odds ratio [OR] = 1.43; 95% CI:1.22, 1.68, p= 0.00001; NNTB = 10). Trough FEV1 was significantly higher at the end of treatment with indacaterol than with TD-LABA (80 ml, p=0.00001). Similarly, indacaterol significantly improved dyspnea (61% greater likelihood of achieving a MCID in TDI, p = 0.008), and health status (21% greater likelihood of achieving a MCID in St. George Respiratory Questionnaire, p=0.04) 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 [PubMed - as supplied by publisher]

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