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Indacaterol for chronic obstructive pulmonary disease: systematic review and meta-analysis.

ABSTRACT: BACKGROUND: Inhaled bronchodilators are the first-line therapy for COPD. Indacaterol is a novel addition to existing long-acting bronchodilators. OBJECTIVES: Systematic review of randomized controlled trials (RCT) ON efficacy and safety of indacaterol as compared: 1) with placebo at different dosages, 2) with existing bronchodilators; (3) as add-on treatment to tiotropium. METHODS: We searched 13 electronic databases, including MEDLINE, EMBASE and CENTRAL, and contacted the manufacturer for unpublished data. Primary outcome was mean FEV1 change at 12(th) week, secondary outcomes included changes in SGRQ, TDI and BODE index at 6 months, exacerbation at 1 year, and worsening of symptoms. RESULTS: Twelve eligible RCTs of moderate risk of bias included data from 10,977 patients. Compared to placebo, indacaterol improved FEV1 by a weighted mean difference (WMD) of 0.16 L (95%CI: 0.15, 0.18 L, p<0.001), homogeneously above the minimally important difference of 0.10 L. It offered clinically relevant improvement in all secondary outcomes except exacerbation. Magnitude of benefit did not differ significantly by dosage, but one treatment related death was reported at 300 ug. Efficacy of Indacaterol was similar to formoterol and salmeterol (FEV1 WMD?=?0.04 L, 95%CI: 0.01 L, 0.07 L, p?=?0.02); and tiotropium (FEV1 WMD?=?0.01 L, 95%CI: -0.01, 0.03 L, p?=?0.61). The use of indacaterol on top of tiotropium yielded additional improvement on FEV1 (WMD?=?0.07 L, 95%CI: 0.05 L, 0.10 L, p<0.001). CONCLUSION: Indacaterol is safe and beneficial for patients with COPD at dosage ?150 ug. It may serve as a good alternative to existing bronchodilators, or as an add-on to tiotropium for unresponsive patients. Use of higher dosage requires further justification.

SUBMITTER: Chung VC

PROVIDER: S-EPMC3743831 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Indacaterol for chronic obstructive pulmonary disease: systematic review and meta-analysis.

Chung Vincent C H VC Ma Polly H X PH Hui David S C DS Tam Wilson W S WW Tang Jin Ling JL

PloS one 20130814 8

<h4>Background</h4>Inhaled bronchodilators are the first-line therapy for COPD. Indacaterol is a novel addition to existing long-acting bronchodilators.<h4>Objectives</h4>Systematic review of randomized controlled trials (RCT) ON efficacy and safety of indacaterol as compared: 1) with placebo at different dosages, 2) with existing bronchodilators; (3) as add-on treatment to tiotropium.<h4>Methods</h4>We searched 13 electronic databases, including MEDLINE, EMBASE and CENTRAL, and contacted the ma ...[more]

PMID: 23967106

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Project description:Chronic obstructive pulmonary disease (COPD) is a common lung disease that causes restricted airflow and breathing problems. Globally, COPD is the third leading cause of death and low- and middle-income countries account for the majority of these deaths. There is limited information on COPD's prevalence in East Africa. Thus the purpose of this systematic review and meta-analysis is to estimate the pooled prevalence of COPD in East Africa.A computerized systematic search using multiple databases was performed in search of relevant English articles from the inception of the databases to August 2023. All the authors independently extracted the data. R and RStudio software were used for statistical analysis. Forest plots and tables were used to represent the data. The statistical heterogeneity was evaluated using I2 statistics. There was heterogeneity between the included articles. Therefore, a meta-analysis of random effects models was used to estimate the overall pooled prevalence of COPD in East Africa. A funnel plot test was used to examine possible publication bias.The database search produced 512 papers. After checking for inclusion and exclusion criteria, 43 full-text observational studies with 68 553 total participants were found suitable for the review. The overall pooled prevalence of COPD in East Africa was 13.322%. The subgroup analysis found the COPD pooled prevalence in the different countries was 18.994%, 7%, 15.745%, 9.032%, 15.026% and 11.266% in Ethiopia, Uganda, Tanzania, Malawi, Sudan, and Kenya, respectively. Additionally, the subgroup analysis of COPD by study setting among community-based studies was 12.132% and 13.575% for hospital-based studies.According to the study's findings, approximately one of every seven individuals in East Africa has COPD, indicating a notably high prevalence of the disease. Thus governments and other stakeholders working on non-communicable disease control should place an emphasis on preventive measures to minimize the burden of COPD.

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Indacaterol for chronic obstructive pulmonary disease: systematic review and meta-analysis.

Publications

Indacaterol for chronic obstructive pulmonary disease: systematic review and meta-analysis.

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