Indacaterol and tiotropium combination therapy in patients with chronic obstructive pulmonary disease.

Abstract

BACKGROUND:

Combination therapy with a long-acting antimuscarinic agent and a long-acting β2-agonist are recommended in chronic obstructive pulmonary disease (COPD) if control is not adequate with one long-acting bronchodilator alone. We evaluated the effects of indacaterol and tiotropium combination therapy, including the effects of adding indacaterol to tiotropium (indacaterol add-on group) and adding tiotropium to indacaterol (tiotropium add-on group).

METHODS:

We recruited 79 patients with COPD already treated with tiotropium or indacaterol. We undertook pulmonary function tests, the COPD assessment test (CAT), and the multi-frequency forced oscillation technique (to measure respiratory resistance and reactance) before and after 8 weeks of indacaterol and tiotropium combination therapy.

RESULTS:

The median age was 72.1 years and the mean forced expiratory volume in 1 s (FEV1) as a proportion of predicted was 57.2 ± 18.3%. After 8 weeks of combination therapy, FEV1 and %predicted FEV1 had increased significantly. There was no change in CAT score. For respiratory impedance, combination therapy improved resistance at 5 Hz (R5) and resistance at 20 Hz (R20) in the whole-breath, inspiratory and expiratory phases, and resonant frequency (Fres) in the inspiratory phase. The indacaterol add-on group (43 patients) and tiotropium add-on group (36 patients) showed improvements in FEV1 and %predicted FEV1 over monotherapy, although the CAT score fell significantly in the indacaterol add-on group (p = 0.005).

CONCLUSIONS:

Indacaterol and tiotropium combination therapy improved airflow limitation and respiratory resistances. Adding indacaterol to tiotropium, or tiotropium to indacaterol, had similar effects on airflow limitation.

• Authors: Sayomi Matsushima, Naoki Inui, Hideki Yasui, Masato Kono, Yutaro Nakamura, Mikio Toyoshima, Toshihiro Shirai, Takafumi Suda
• Journal: Pulmonary pharmacology & therapeutics (Pulm Pharmacol Ther) Vol. 30 Pg. 11-5 (Feb 2015) ISSN: 1522-9629 [Electronic] England
• PMID: 25445929 (Publication Type: Clinical Trial, Journal Article, Multicenter Study)
• Copyright: Copyright © 2014 Elsevier Ltd. All rights reserved.

Chemical References

• Adrenergic beta-2 Receptor Agonists
• Bronchodilator Agents
• Indans
• Quinolones
• Scopolamine Derivatives
• indacaterol
• Tiotropium Bromide

Topics

• Adrenergic beta-2 Receptor Agonists (administration & dosage, therapeutic use)
• Aged
• Aged, 80 and over
• Bronchodilator Agents (administration & dosage, therapeutic use)
• Drug Therapy, Combination
• Female
• Forced Expiratory Volume (drug effects)
• Humans
• Indans (administration & dosage, therapeutic use)
• Male
• Middle Aged
• Pulmonary Disease, Chronic Obstructive (drug therapy, physiopathology)
• Quinolones (administration & dosage, therapeutic use)
• Respiratory Function Tests
• Scopolamine Derivatives (administration & dosage, therapeutic use)
• Tiotropium Bromide
• Treatment Outcome