Comparative efficacy of indacaterol 150 mu g and 300 mu g versus fixed-dose combinations of formoterol plus budesonide or salmeterol plus fluticasone for the treatment of chronic obstructive pulmonary disease - a network meta-analysis

Comparative efficacy of indacaterol 150 mu g and 300 mu g versus fixed-dose combinations of formoterol plus budesonide or salmeterol plus fluticasone for the treatment of chronic obstructive pulmonary disease - a network meta-analysis

Author Cope, Shannon Google Scholar
Capkun-Niggli, Gorana Google Scholar
Gale, Rupert Google Scholar
Jardim, Jose Roberto Autor UNIFESP Google Scholar
Jansen, Jeroen P. Google Scholar
Institution Mapi Values
Novartis Pharma AG
Novartis Horsham Res Ctr
Universidade Federal de São Paulo (UNIFESP)
Abstract Objective: To compare efficacy of indacaterol to that of fixed-dose combination (FDC)-formoterol and budesonide (FOR/BUD) and FDC salmeterol and fluticasone (SAL/FP) for the treatment of chronic obstructive pulmonary disease (COPD) based on the available randomized clinical trials (RCTs).Methods: Fifteen placebo-controlled RCTs were included that evaluated: indacaterol 150 mu g (n = 5 studies), indacaterol 300 mu g (n = 4), FOR/BUD 9/160 mu g (n = 2), FOR/BUD 9/320 mu g (n = 3), SAL/FP 50/500 mu g (n = 5), and SAL/FP 50/250 mu g (n = 1). Outcomes of interest were trough forced expiratory volume in 1 second (FEV1), total scores for St. George's Respiratory Questionnaire (SGRQ), and transition dyspnea index (TDI). All trials were analyzed simultaneously using a Bayesian network meta-analysis and relative treatment effects between all regimens were obtained. Treatment-by-covariate interactions were included where possible to improve the similarity of the trials.Results: Indacaterol 150 mu g resulted in a higher change from baseline (CFB) in FEV1 at 12 weeks compared to FOR/BUD 9/160 mu g (difference in CFB 0.11 L [95% credible intervals: 0.08, 0.13]) and FOR/BUD 9/320 mu g (0.09 L [0.06, 0.11]) and was comparable to SAL/FP 50/250 mu g (0.02 L [-0.04, 0.08]) and SAL/FP 50/500 mu g (0.03 L [0.00, 0.06]). Similar results were observed for indacaterol 300 mu g at 12 weeks and indacaterol 150/300 mu g at 6 months. Indacaterol 150 mu g demonstrated comparable improvement in SGRQ total score at 6 months versus FOR/BUD (both doses), and SAL/FP 50/500 mu g (-2.16 point improvement [-4.96, 0.95]). Indacaterol 150 and 300 mu g demonstrated comparable TDI scores versus SAL/FP 50/250 mu g (0.21 points (-0.57, 0.99); 0.39 [-0.39, 1.17], respectively) and SAL/FP 50/500 mu g at 6 months.Conclusion: Indacaterol monotherapy is expected to be at least as good as FOR/BUD (9/320 and 9/160 mu g) and comparable to SAL/FP (50/250 and 50/500 mu g) in terms of lung function. Indacaterol is also expected to be comparable to FOR/BUD (9/320 and 9/160 mu g) and SAL/FP 50/500 mu g in terms of health status and to SAL/FP (50/250 and 50/500 mu g) in terms of breathlessness.
Keywords COPD
network meta-analysis
indacaterol
Language English
Sponsor Novartis Pharma AG
Date 2011-01-01
Published in International Journal of Chronic Obstructive Pulmonary Disease. Albany: Dove Medical Press Ltd, v. 6, p. 329-344, 2011.
ISSN 1176-9106 (Sherpa/Romeo, impact factor)
Publisher Dove Medical Press Ltd
Extent 329-344
Origin http://dx.doi.org/10.2147/COPD.S18759
Access rights Open access Open Access
Type Review
Web of Science ID WOS:000208709800036
URI http://repositorio.unifesp.br/handle/11600/33230

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