Efficacy and safety of 3 dosages of indacaterol for moderate to severe COPD: a network meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

HOU Nian , SHI Kai , LI Fei ,  LIU Xiaoju

Department of Gerontal Respiratory Medicine, the First Hospital of Lanzhou University, Lanzhou, 730000, P.R.China;

Corresponding author：

LIU Xiaoju, Email: liuxiaoju835@126.com

Keywords：

Indacaterol; Chronic obstructive pulmonary disease; Efficacy; Safety; Randomized controlled trial; Network meta-analysis

DOI：

10.7507/1672-2531.201902038

Video：

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Objectives To assess the efficacy and safety of 3 dosages (75, 150, and 300 μg) of indacaterol in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) by network meta-analysis.Methods PubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of indacaterol for treating stable COPD patients from inception to December 31^st, 2018. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies, and then ADDIS 1.16.8 and Stata 15.1 softwares were used to perform network meta-analysis.Results A total of 13 RCTs involving 5 476 patients were included. The results of network meta-analysis showed that: compared to placebo, 3 dosages of indacaterol could improve trough forced expiratory volume in 1 second (trough FEV₁), lower St George respiratory questionnaire (SGRQ), and improve transitional dyspnea index (TDI). 150 μg and 300 μg groups were better than placebo group in reducing COPD exacerbation rate. There were no statistically differences between groups in incidence of all adverse effects. Ranking probability table showed that 300 μg group was most likely to be the most effective treatment in improving trough FEV₁, SGRQ and TDI, and it ranked second in reducing COPD exacerbation rate.Conclusions Considering the network meta-analysis and rankings, 300 μg indacaterol is superior to the other 2 dosages in treating the patients with moderate-to-severe COPD.

Citation： HOU Nian, SHI Kai, LI Fei, LIU Xiaoju. Efficacy and safety of 3 dosages of indacaterol for moderate to severe COPD: a network meta-analysis. Chinese Journal of Evidence-Based Medicine, 2019, 19(8): 924-931. doi: 10.7507/1672-2531.201902038 Copy

1.	Singh D, Agusti A, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease: the GOLD Science Committee Report 2019. Eur Respir J, 2019, 53(5): 1900164.
2.	Wang C, Xu J, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health[CPH] study): a national cross-sectional study. Lancet, 2018, 391(10131): 1706-1717.
3.	Geake JB, Dabscheck EJ, Wood-Baker R, et al. Indacaterol, a once-daily beta2-agonist, versus twice-daily beta₂-agonists or placebo for chronic obstructive pulmonary disease. Cochrane Database Syst Rev, 2015, 1: CD010139.
4.	Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease 2017 report. Available at: Http://www.goldcopd.org/gold-reports/.
5.	Higgins JP, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ, 2011, 343: d5928.
6.	张超, 鄢金柱, 孙凤, 等. 网状 Meta 分析一致性的鉴别与处理方法. 中国循证医学杂志, 2014, 14(7): 884-888.
7.	Bateman ED, Ferguson GT, Barnes N, et al. Dual bronchodilation with QVA149 versus single bronchodilator therapy: the SHINE study. Eur Respir J, 2013, 42(6): 1484-1494.
8.	Chapman KR, Rennard SI, Dogra A, et al. Long-term safety and efficacy of indacaterol, a long-acting β-agonist, in subjects with COPD: a randomized, placebo-controlled study. Chest, 2011, 140(1): 68-75.
9.	Dahl R, Chung KF, Buhl R, et al. Efficacy of a new once-daily long-acting inhaled beta₂-agonist indacaterol versus twice-daily formoterol in COPD. Thorax, 2010, 65(6): 473-479.
10.	Donohue JF, Fogarty C, Lötvall J, et al. Once-daily bronchodilators for chronic obstructive pulmonary disease: indacaterol versus tiotropium. Am J Respir Crit Care Med, 2010, 182(2): 155-162.
11.	Feldman G, Siler T, Prasad N, et al. Efficacy and safety of indacaterol 150 microg once-daily in COPD: a double-blind, randomised, 12-week study. BMC Pulm Med, 2010, 10: 11.
12.	Gotfried MH, Kerwin EM, Lawrence D, et al. Efficacy of indacaterol 75 μg once-daily on dyspnea and health status: results of two double-blind, placebo-controlled 12-week studies. COPD, 2012, 9(6): 629-636.
13.	Kerwin EM, Gotfried MH, Lawrence D, et al. Efficacy and tolerability of indacaterol 75 μg once daily in patients aged ≥40 years with chronic obstructive pulmonary disease: results from 2 double-blind, placebo-controlled 12-week studies. Clin Ther, 2011, 33(12): 1974-1984.
14.	Kinoshita M, Lee SH, Hang LW, et al. Efficacy and safety of indacaterol 150 and 300 μg in chronic obstuctive pulmonary disease patients from six asian areas including Japan: A 12-week, placebo-controlled study. Respirology, 2012, 17(2): 379-389.
15.	Van de Maele B, Fabbri LM, Martin C, et al. Cardiovascular safety of QVA149, a combination of Indacaterol and NVA237, in COPD patients. COPD, 2010, 7(6): 418-427.
16.	Yao W, Wang C, Zhong N, et al. Effect of once-daily indacaterol in a predominantly Chinese population with chronic obstructive pulmonary disease: a 26-week Asia-Pacific study. Respirology, 2014, 19(2): 231-238.
17.	段玲, 陈章, 肖贞良. 茚达特罗对 COPD 患者日常活动影响的研究. 西南国防医药, 2015, 25(4): 369-372.
18.	龚峰. 慢性阻塞性肺疾病的临床治疗研究. 中国农村卫生事业管理, 2015, 35(5): 671-673.
19.	侯小花, 郭莲香, 许新举. 茚达特罗联合噻托溴铵治疗慢性阻塞性肺疾病患者临床疗效观察. 内科, 2017, 12(6): 770-772.
20.	Jones PW. Interpreting thresholds for a clinically significant change in health status in asthma and COPD. Eur Respir J, 2002, 19(3): 398-404.
21.	Witek TJ Jr, Mahler DA. Minimal important difference of the transition dyspnoea index in a multinational clinical trial. Eur Respir J, 2003, 21(2): 267-272.
22.	Barr RG, Celli BR, Mannino DM, et al. Comorbidities, patient knowledge, and disease management in a national sample of patients with COPD. Am J Med, 2009, 122(4): 348-355.
23.	Salpeter SR, Buckley NS, Ormiston TM, et al. Meta-analysis: effect of long-acting beta-agonists on severe asthma exacerbations and asthma-related deaths. Ann Intern Med, 2006, 144(12): 904-912.
24.	Donohue JF, Singh D, Kornmann O, et al. Safety of indacaterol in the treatment of patients with COPD. Int J Chron Obstruct Pulmon Dis, 2011, 6: 477-492.

1. Singh D, Agusti A, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease: the GOLD Science Committee Report 2019. Eur Respir J, 2019, 53(5): 1900164.
2. Wang C, Xu J, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health[CPH] study): a national cross-sectional study. Lancet, 2018, 391(10131): 1706-1717.
3. Geake JB, Dabscheck EJ, Wood-Baker R, et al. Indacaterol, a once-daily beta2-agonist, versus twice-daily beta₂-agonists or placebo for chronic obstructive pulmonary disease. Cochrane Database Syst Rev, 2015, 1: CD010139.
4. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease 2017 report. Available at: Http://www.goldcopd.org/gold-reports/.
5. Higgins JP, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ, 2011, 343: d5928.
6. 张超, 鄢金柱, 孙凤, 等. 网状 Meta 分析一致性的鉴别与处理方法. 中国循证医学杂志, 2014, 14(7): 884-888.
7. Bateman ED, Ferguson GT, Barnes N, et al. Dual bronchodilation with QVA149 versus single bronchodilator therapy: the SHINE study. Eur Respir J, 2013, 42(6): 1484-1494.
8. Chapman KR, Rennard SI, Dogra A, et al. Long-term safety and efficacy of indacaterol, a long-acting β-agonist, in subjects with COPD: a randomized, placebo-controlled study. Chest, 2011, 140(1): 68-75.
9. Dahl R, Chung KF, Buhl R, et al. Efficacy of a new once-daily long-acting inhaled beta₂-agonist indacaterol versus twice-daily formoterol in COPD. Thorax, 2010, 65(6): 473-479.
10. Donohue JF, Fogarty C, Lötvall J, et al. Once-daily bronchodilators for chronic obstructive pulmonary disease: indacaterol versus tiotropium. Am J Respir Crit Care Med, 2010, 182(2): 155-162.
11. Feldman G, Siler T, Prasad N, et al. Efficacy and safety of indacaterol 150 microg once-daily in COPD: a double-blind, randomised, 12-week study. BMC Pulm Med, 2010, 10: 11.
12. Gotfried MH, Kerwin EM, Lawrence D, et al. Efficacy of indacaterol 75 μg once-daily on dyspnea and health status: results of two double-blind, placebo-controlled 12-week studies. COPD, 2012, 9(6): 629-636.
13. Kerwin EM, Gotfried MH, Lawrence D, et al. Efficacy and tolerability of indacaterol 75 μg once daily in patients aged ≥40 years with chronic obstructive pulmonary disease: results from 2 double-blind, placebo-controlled 12-week studies. Clin Ther, 2011, 33(12): 1974-1984.
14. Kinoshita M, Lee SH, Hang LW, et al. Efficacy and safety of indacaterol 150 and 300 μg in chronic obstuctive pulmonary disease patients from six asian areas including Japan: A 12-week, placebo-controlled study. Respirology, 2012, 17(2): 379-389.
15. Van de Maele B, Fabbri LM, Martin C, et al. Cardiovascular safety of QVA149, a combination of Indacaterol and NVA237, in COPD patients. COPD, 2010, 7(6): 418-427.
16. Yao W, Wang C, Zhong N, et al. Effect of once-daily indacaterol in a predominantly Chinese population with chronic obstructive pulmonary disease: a 26-week Asia-Pacific study. Respirology, 2014, 19(2): 231-238.
17. 段玲, 陈章, 肖贞良. 茚达特罗对 COPD 患者日常活动影响的研究. 西南国防医药, 2015, 25(4): 369-372.
18. 龚峰. 慢性阻塞性肺疾病的临床治疗研究. 中国农村卫生事业管理, 2015, 35(5): 671-673.
19. 侯小花, 郭莲香, 许新举. 茚达特罗联合噻托溴铵治疗慢性阻塞性肺疾病患者临床疗效观察. 内科, 2017, 12(6): 770-772.
20. Jones PW. Interpreting thresholds for a clinically significant change in health status in asthma and COPD. Eur Respir J, 2002, 19(3): 398-404.
21. Witek TJ Jr, Mahler DA. Minimal important difference of the transition dyspnoea index in a multinational clinical trial. Eur Respir J, 2003, 21(2): 267-272.
22. Barr RG, Celli BR, Mannino DM, et al. Comorbidities, patient knowledge, and disease management in a national sample of patients with COPD. Am J Med, 2009, 122(4): 348-355.
23. Salpeter SR, Buckley NS, Ormiston TM, et al. Meta-analysis: effect of long-acting beta-agonists on severe asthma exacerbations and asthma-related deaths. Ann Intern Med, 2006, 144(12): 904-912.
24. Donohue JF, Singh D, Kornmann O, et al. Safety of indacaterol in the treatment of patients with COPD. Int J Chron Obstruct Pulmon Dis, 2011, 6: 477-492.

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Efficacy and safety of 3 dosages of indacaterol for moderate to severe COPD: a network meta-analysis

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