Tags

Type your tag names separated by a space and hit enter

Effects of long-acting bronchodilators in COPD patients according to COPD severity and ICS use.
Respir Med. 2013 Feb; 107(2):223-32.RM

Abstract

BACKGROUND

Indacaterol is a once-daily, long-acting β(2)-agonist bronchodilator that improves dyspnoea and health status in patients with moderate-to-severe COPD. While its bronchodilator effects have been shown to be maintained in different patient subgroups, effects on clinical outcomes in certain subgroups are not yet defined.

METHODS

Post-hoc analysis of pooled clinical study data to investigate efficacy and safety of indacaterol compared with placebo and other long-acting bronchodilators (formoterol, salmeterol, open-label tiotropium) in patient subgroups defined by COPD severity (GOLD stage II or III; n = 4082) and ICS use at baseline (no/yes; n = 4088). Efficacy outcomes were trough (24-h post-dose) FEV(1), dyspnoea (transition dyspnoea index; TDI) and health status (St George's Respiratory Questionnaire; SGRQ) after 26 weeks.

RESULTS

All active treatments significantly improved trough FEV(1) and dyspnoea compared with placebo, and all apart from open-label tiotropium improved health status compared with placebo. Among active treatments, indacaterol 150 μg had the best overall efficacy profile in the GOLD II and no-ICS subgroups. In the GOLD III and ICS subgroups, indacaterol 300 μg had the best overall efficacy, including a marked effect on dyspnoea (1.4-point improvement in TDI total score vs. placebo; p < 0.001). Within subgroups, the incidence of adverse events was similar between treatments.

CONCLUSION

Indacaterol maintained its efficacy regardless of disease severity or use of concurrent ICS. Indacaterol 150 μg had the best overall efficacy profile in the GOLD stage II patients while, in patients with more severe disease, indacaterol 300 μg provided useful improvements in dyspnoea.

Authors+Show Affiliations

Respiratory Division, University Hospitals, Herestraat 49, B-3000 Leuven, Belgium. Marc.Decramer@uzleuven.beNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23219347

Citation

Decramer, Marc, et al. "Effects of Long-acting Bronchodilators in COPD Patients According to COPD Severity and ICS Use." Respiratory Medicine, vol. 107, no. 2, 2013, pp. 223-32.
Decramer M, Dahl R, Kornmann O, et al. Effects of long-acting bronchodilators in COPD patients according to COPD severity and ICS use. Respir Med. 2013;107(2):223-32.
Decramer, M., Dahl, R., Kornmann, O., Korn, S., Lawrence, D., & McBryan, D. (2013). Effects of long-acting bronchodilators in COPD patients according to COPD severity and ICS use. Respiratory Medicine, 107(2), 223-32. https://doi.org/10.1016/j.rmed.2012.10.022
Decramer M, et al. Effects of Long-acting Bronchodilators in COPD Patients According to COPD Severity and ICS Use. Respir Med. 2013;107(2):223-32. PubMed PMID: 23219347.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of long-acting bronchodilators in COPD patients according to COPD severity and ICS use. AU - Decramer,Marc, AU - Dahl,Ronald, AU - Kornmann,Oliver, AU - Korn,Stephanie, AU - Lawrence,David, AU - McBryan,Danny, Y1 - 2012/12/06/ PY - 2012/04/30/received PY - 2012/09/26/revised PY - 2012/10/30/accepted PY - 2012/12/11/entrez PY - 2012/12/12/pubmed PY - 2013/6/26/medline SP - 223 EP - 32 JF - Respiratory medicine JO - Respir Med VL - 107 IS - 2 N2 - BACKGROUND: Indacaterol is a once-daily, long-acting β(2)-agonist bronchodilator that improves dyspnoea and health status in patients with moderate-to-severe COPD. While its bronchodilator effects have been shown to be maintained in different patient subgroups, effects on clinical outcomes in certain subgroups are not yet defined. METHODS: Post-hoc analysis of pooled clinical study data to investigate efficacy and safety of indacaterol compared with placebo and other long-acting bronchodilators (formoterol, salmeterol, open-label tiotropium) in patient subgroups defined by COPD severity (GOLD stage II or III; n = 4082) and ICS use at baseline (no/yes; n = 4088). Efficacy outcomes were trough (24-h post-dose) FEV(1), dyspnoea (transition dyspnoea index; TDI) and health status (St George's Respiratory Questionnaire; SGRQ) after 26 weeks. RESULTS: All active treatments significantly improved trough FEV(1) and dyspnoea compared with placebo, and all apart from open-label tiotropium improved health status compared with placebo. Among active treatments, indacaterol 150 μg had the best overall efficacy profile in the GOLD II and no-ICS subgroups. In the GOLD III and ICS subgroups, indacaterol 300 μg had the best overall efficacy, including a marked effect on dyspnoea (1.4-point improvement in TDI total score vs. placebo; p < 0.001). Within subgroups, the incidence of adverse events was similar between treatments. CONCLUSION: Indacaterol maintained its efficacy regardless of disease severity or use of concurrent ICS. Indacaterol 150 μg had the best overall efficacy profile in the GOLD stage II patients while, in patients with more severe disease, indacaterol 300 μg provided useful improvements in dyspnoea. SN - 1532-3064 UR - https://www.unboundmedicine.com/medline/citation/23219347/Effects_of_long_acting_bronchodilators_in_COPD_patients_according_to_COPD_severity_and_ICS_use_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0954-6111(12)00408-8 DB - PRIME DP - Unbound Medicine ER -