Role of Indacaterol in the Treatment of COPD

Abstract

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 side-effects. 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.