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Role of Indacaterol in the Treatment of COPD
March 2014, Vol 145, No. 3_MeetingAbstracts Obstructive Lung Diseases | March 2014
Role of Indacaterol in the Treatment of COPD Raja Dhar, MD; Sanjit Ray Chaudhuri Fortis hospital, Kolkata, India
Chest. 2014;145(3_MeetingAbstracts):387A. doi:10.1378/chest.1836357
Abstract SESSION TITLE: COPD Posters SESSION TYPE: Poster Presentations PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM PURPOSE: Indacaterol is an ultra-long-acting beta-adrenoceptor agonist which needs to be taken once a day, licensed only for the treatment of chronic obstructive pulmonary disease (COPD). It is delivered as an aerosol formulation through a dry powder inhaler. A year-long, placebo-controlled trial published in July 2010 suggests indacaterol may be significantly more effective than twice-daily formoterol in improving FEV1. There were some reductions in the need for rescue medication, but these were not significantly different; nor was there any difference in the rate of exacerbation between the 2 active treatments. We looked at our data regarding the use of Indacaterol in a tertiary care set up. This is a real life experience looking at how Indacaterol influences clinical (MRC dyspnoea scale) and physiological (Spirometry) parameters and exacerbation episodes. METHODS: We did a prospective study looking at the use of Indacaterol in 50 consecutive patients. It could be used in conjunction with other medications for COPD. The patients should have been on Indacaterol for at least 3 months. We looked at all parameters including Spirometry, MRC dyspnoea scale, use of rescue medications, exacerbations (use of oral steroids, emergency visits, hospitalisation and ventilation) and 6 minute walk test. RESULTS: 76% of our patients were men with a mean age of 67.3±8.6 years. The patients were on Indacaterol for a mean of 136 days. Use of Indacaterol showed significant improvement in Spirometry, 6 minute walk test and MRC dyspnoea scale. It also showed significant reduction in use of rescue medications and all
exacerbations. The medication was also shown to be well tolerated with minimal sideeffects. CONCLUSIONS: Indacaterol is a useful adjunct to standard treatment for COPD causing significant improvement in clinical and physiological parameters. We need further longitudinal studies to establish its long-term efficacy. CLINICAL IMPLICATIONS: This study provides evidence for the usefulness of the newest Long acting Beta agonist (LABA) in day to day clinical practice. The improved results we have obtained (compared to available RCTs) is because the drug has been used in conjunction with other available agents for stable COPD. This shows its relevance in routine clinical practice where multiple agents are usually combined together for moderate to severe disease and also underlines the importance of using bronchodilators as first line for stable COPD as recommended by the GOLD guidelines. DISCLOSURE: The following authors have nothing to disclose: Raja Dhar, Sanjit Ray Chaudhuri No Product/Research Disclosure Information
Role of Indacaterol in the Treatment of COPD Raja Dhar, MD; Sanjit Ray Chaudhuri Fortis hospital, Kolkata, India
Chest. 2014;145(3_MeetingAbstracts):387A. doi:10.1378/chest.1836357
Abstract SESSION TITLE: COPD Posters SESSION TYPE: Poster Presentations PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM PURPOSE: Indacaterol is an ultra-long-acting beta-adrenoceptor agonist which needs to be taken once a day, licensed only for the treatment of chronic obstructive pulmonary disease (COPD). It is delivered as an aerosol formulation through a dry powder inhaler. A year-long, placebo-controlled trial published in July 2010 suggests indacaterol may be significantly more effective than twice-daily formoterol in improving FEV1. There were some reductions in the need for rescue medication, but these were not significantly different; nor was there any difference in the rate of exacerbation between the 2 active treatments. We looked at our data regarding the use of Indacaterol in a tertiary care set up. This is a real life experience looking at how Indacaterol influences clinical (MRC dyspnoea scale) and physiological (Spirometry) parameters and exacerbation episodes. METHODS: We did a prospective study looking at the use of Indacaterol in 50 consecutive patients. It could be used in conjunction with other medications for COPD. The patients should have been on Indacaterol for at least 3 months. We looked at all parameters including Spirometry, MRC dyspnoea scale, use of rescue medications, exacerbations (use of oral steroids, emergency visits, hospitalisation and ventilation) and 6 minute walk test. RESULTS: 76% of our patients were men with a mean age of 67.3±8.6 years. The patients were on Indacaterol for a mean of 136 days. Use of Indacaterol showed significant improvement in Spirometry, 6 minute walk test and MRC dyspnoea scale. It also showed significant reduction in use of rescue medications and all
exacerbations. The medication was also shown to be well tolerated with minimal sideeffects. CONCLUSIONS: Indacaterol is a useful adjunct to standard treatment for COPD causing significant improvement in clinical and physiological parameters. We need further longitudinal studies to establish its long-term efficacy. CLINICAL IMPLICATIONS: This study provides evidence for the usefulness of the newest Long acting Beta agonist (LABA) in day to day clinical practice. The improved results we have obtained (compared to available RCTs) is because the drug has been used in conjunction with other available agents for stable COPD. This shows its relevance in routine clinical practice where multiple agents are usually combined together for moderate to severe disease and also underlines the importance of using bronchodilators as first line for stable COPD as recommended by the GOLD guidelines. DISCLOSURE: The following authors have nothing to disclose: Raja Dhar, Sanjit Ray Chaudhuri No Product/Research Disclosure Information