indacaterol and Cough

We investigated the effects of indacaterol on cough and phlegm in patients with stable chronic obstructive pulmonary disease (COPD). We performed a meta-analysis with five randomized controlled trials (RCTs) of indacaterol in stable COPD patients. The symptom severity was defined using the St. George's Respiratory Questionnaire (SGRQ). We analyzed patients treated with 150 µg (n = 945) and 300 µg (n = 832) out of 3,325 patients who completed the SGRQ from five RCTs. After a 12-week treatment of 150 µg indacaterol, cough improvement was reported in 36.5% (316/866) of patients treated with indacaterol vs. 32.2% (259/804) patients treated with placebo (Relative Ratio [RR], 1.13; 95% confidence interval [CI], 0.99-1.29). Phlegm improvement was reported in 31.0% (247/798) of patients treated with indacaterol vs. 30.6% (225/736) of patients treated with placebo (RR, 1.01; 95% CI, 0.87-1.18). Dyspnea improvement was reported in 39.5% (324/820) of patients treated with indacaterol vs. 31.5% (237/753) patients treated with placebo (RR, 1.33; 95% CI, 1.03-1.71; P = 0.001, I(2) = 55.1%). Only dyspnea improvement was significant compared to placebo even at the 300 µg indacaterol dose. Compared to placebo, a 12-week treatment of the long-acting beta-agonist, indacaterol might not have a significant effect on cough or phlegm in stable COPD.

Topics: Administration, Inhalation; Anti-Bacterial Agents; Bronchodilator Agents; Cough; Dyspnea; Forced Expiratory Volume; Humans; Indans; Placebos; Pulmonary Disease, Chronic Obstructive; Quinolones; Sputum; Surveys and Questionnaires; Treatment Outcome

Inhaled long-acting bronchodilators are the mainstay of pharmacotherapy for chronic obstructive pulmonary disease (COPD). Both the twice-daily long-acting β(2)-adrenoceptor agonists (LABAs) salmeterol and formoterol and the once-daily LABA indacaterol are indicated for use in COPD. This review examines current evidence for the safety of LABAs in COPD, focusing on their effect on exacerbations and deaths.. We searched PubMed for placebo-controlled studies evaluating long-term (≥24 weeks) use of formoterol, salmeterol, or indacaterol in patients with stable COPD, published between January 1990 and September 2012. We summarized data relating to exacerbations and adverse events, particularly events related to COPD.. From 20 studies examined (8774 LABA-treated patients), there was no evidence of an association between LABA treatment and increased exacerbations, COPD-related adverse events, or deaths. Where analyzed as an efficacy outcome, LABA treatment was generally associated with significant or numerical reductions in COPD exacerbations compared with placebo. Incidences of COPD-related adverse events were similar for active and placebo treatments. The incidence of adverse events typically associated with the β(2)-agonist drug class such as skeletal muscle tremors and palpitations was low (often <1% of patients), and there were no reports of increased incidence of cardiac arrhythmias. The systemic effects of β(2)-adrenoceptor stimulation, such as high glucose and potassium levels, were considered minor.. Current evidence from clinical studies of the safety and tolerability profile of LABAs supports their long-term use in COPD.

Topics: Adrenergic beta-2 Receptor Agonists; Albuterol; Blood Glucose; Cough; Ethanolamines; Formoterol Fumarate; Headache; Humans; Indans; Nasopharyngitis; Potassium; Pulmonary Disease, Chronic Obstructive; Quinolones; Respiratory Tract Infections; Salmeterol Xinafoate; Spasm; Tachycardia; Tremor

▾Indacaterol powder for inhalation (Onbrez Breezhaler - Novartis) is a long-acting beta(2) agonist, licensed for once-daily use as maintenance bronchodilator therapy for chronic obstructive pulmonary disease (COPD). In this article, we consider the evidence for indacaterol and how its use fits with current management strategies for COPD.

Topics: Administration, Inhalation; Adrenergic beta-2 Receptor Agonists; Bronchodilator Agents; Cough; Dose-Response Relationship, Drug; Forced Expiratory Volume; Humans; Indans; Practice Guidelines as Topic; Pulmonary Disease, Chronic Obstructive; Quinolones; Randomized Controlled Trials as Topic; Respiratory Function Tests; Severity of Illness Index; United Kingdom