Abstract

BackgroundIndacaterol is a long-acting beta-2 agonist for once-daily treatment of COPD. We evaluated the effects of indacaterol 150 μg on lung hyperinflation compared with placebo and open-label tiotropium 18 μg. We measured physical activity during treatment with indacaterol 150 μg and matched placebo.MethodsWe performed a randomized, three-period, cross-over study (21 days of treatment separated by two wash-out periods of 13 days) with indacaterol 150 μg or matching placebo and tiotropium 18 μg. Lung function was assessed by body plethysmography and spirometry. Physical activity was measured for one week by a multisensory armband at the end of both treatment periods with indacaterol/matched placebo. The primary endpoint was peak inspiratory capacity at the end of each treatment period.Results129 patients (mean age, 61 years; mean post-bronchodilator FEV1, 64%), were randomized and 110 patients completed the study. Peak inspiratory capacity was 0.22 L greater with Indacaterol at day 21 compared to placebo (p < 0.001). Similar results were observed for tiotropium. Both bronchodilators also significantly improved other parameters of lung hyperinflation compared with placebo. All parameters of physical activity were significantly increased during treatment with indacaterol versus placebo.ConclusionsIndacaterol 150 μg improved lung hyperinflation in patients with moderate COPD, which was associated with an increase of physical activity.Trial registrationClinicalTrials.gov registration number: NCT01012765.

Highlights

  • Indacaterol is a long-acting beta-2 agonist for once-daily treatment of Chronic obstructive pulmonary disease (COPD)

  • The main findings of the present study are that indacaterol and tiotropium provided significant improvements in lung hyperinflation after three weeks of treatment, and that physical activity measured by a multisensory accelerometer was significantly improved during treatment with indacaterol compared to placebo

  • The rationale behind the use of long-acting bronchodilators is the sustained reduction of lung hyperinflation with an increase of inspiratory capacity (IC), which in turn is related to an improvement of exertional dyspnea and exercise intolerance in COPD [2,26]

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Summary

Introduction

Indacaterol is a long-acting beta-2 agonist for once-daily treatment of COPD. We measured physical activity during treatment with indacaterol 150 μg and matched placebo. Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that results in air trapping and lung hyperinflation [1,2,3]. Significant limitations of physical activity are already present in patients with moderate COPD [5,6]. Indacaterol is an inhaled ultralong-acting β2-agonist providing 24-h bronchodilation with once-daily dosing in patients with COPD [14]. Indacaterol has been demonstrated to improve airflow limitation, dyspnea, and exercise intolerance in patients with COPD [14,15,16,17]

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