Indacaterol: in chronic obstructive pulmonary disease

Abstract

Indacaterol is a long-acting β₂-adrenoceptor agonist that is available in the EU for the maintenance treatment of airflow obstruction in adult patients with chronic obstructive pulmonary disease (COPD). Indacaterol has a 24-hour bronchodilatory effect, which allows for once-daily administration. The onset of bronchodilation after inhalation of indacaterol is fast, with significant improvements versus placebo seen 5 minutes after inhalation. In four large (n > 400), randomized, double-blind, placebo-controlled, multicentre phase III trials, patients with COPD who received indacaterol 150 or 300 μg once daily had a significantly higher mean trough forced expiratory volume in 1 second (FEV₁) than placebo recipients after 12 weeks. Trough FEV₁ differences between indacaterol and placebo recipients were 130-180 mL and exceeded the clinically relevant threshold of 120 mL in all trials. Furthermore, indacaterol recipients had significantly higher mean trough FEV₁ values after 12 weeks than patients who received formoterol, salmeterol or open-label tiotropium. COPD exacerbations and symptoms, and health-related quality of life were also significantly improved for indacaterol versus placebo recipients in some studies. Indacaterol was generally well tolerated by adults with moderate to severe COPD.