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BackgroundThis is a meta-analysis of the safety and efficacy of indacaterol in chronic obstructive pulmonary disease (COPD) with treatment duration of ≥12 weeks.MethodsRandomized controlled trials (RCTs) reported in English (to September 30, 2012) were identified from PubMed, the Cochrane Library, Embase, websites, reference lists, and manual searches. Two reviewers independently assessed the quality of the trials and extracted information.ResultsFive RCTs were eligible. Five involved indacaterol, two salmeterol, one formoterol, and one tiotropium. Four studies had placebos. Using trough forced expiratory volume in 1 s as a measure of therapeutic effect, indacaterol was superior to the other β2-agonists, tiotropium, and placebo at weeks 12, 26, and 52. Indacaterol had a greater effect on the transition dyspnoea index compared with placebo, formoterol, and salmeterol, but not open-label tiotropium. In reducing the as-needed use of salbutamol, indacaterol were superior to placebo, tiotropium, and formoterol, but not salmeterol (5, 95 % confidence interval (CI), -2.15, 12.15). Indacaterol improved St George's Respiratory Questionnaire scores more than placebo and open-label tiotropium, but not formoterol. Indacaterol seemed to cause more adverse events than placebo only at a dose of 600 μg daily and a duration of 52 weeks (risk ratio 1.15; 95 % CI, 1.04, 1.26). The total and serious adverse events and adverse events leading to discontinuation were comparable with open-label tiotropium and the β2-agonists.ConclusionsIndacaterol is effective and well-tolerated as a bronchodilator for the maintenance of moderate to severe COPD.

Original publication

DOI

10.1007/s00408-012-9444-2

Type

Journal article

Journal

Lung

Publication Date

04/2013

Volume

191

Pages

135 - 146

Addresses

Department of Respiratory Medicine, West China Medical School and West China Hospital, Sichuan University, Chengdu, 610000, Sichuan, China.

Keywords

Lung, Humans, Pulmonary Disease, Chronic Obstructive, Quinolones, Indans, Bronchodilator Agents, Vital Capacity, Forced Expiratory Volume, Treatment Outcome, Drug Administration Schedule, Severity of Illness Index, Odds Ratio, Chi-Square Distribution, Evidence-Based Medicine, Recovery of Function, Time Factors, Aged, Middle Aged, Female, Male, Randomized Controlled Trials as Topic, Adrenergic beta-2 Receptor Agonists