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Comparison of Clinical Efficacy and Safety between Indacaterol and Tiotropium in COPD: Meta-Analysis of Randomized Controlled Trials

Two once-daily inhaled bronchodilators, indacaterol and tiotropium, are widely used as first-line therapy in stable COPD patients. This study was performed to compare the clinical efficacy and safety between indacaterol and tiotropium in patients with moderate-to-severe COPD. MEDLINE, EMBASE, and Co...

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Autores principales: Kim, Jung Soo, Park, Jinkyeong, Lim, Seong Yong, Oh, Yeon-Mok, Yoo, Kwang Ha, Park, Yong Bum, Sheen, Seung Soo, Kim, Min-Ji, Carriere, K. C., Jung, Ji Ye, Park, Hye Yun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370711/
https://www.ncbi.nlm.nih.gov/pubmed/25799171
http://dx.doi.org/10.1371/journal.pone.0119948
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author Kim, Jung Soo
Park, Jinkyeong
Lim, Seong Yong
Oh, Yeon-Mok
Yoo, Kwang Ha
Park, Yong Bum
Sheen, Seung Soo
Kim, Min-Ji
Carriere, K. C.
Jung, Ji Ye
Park, Hye Yun
author_facet Kim, Jung Soo
Park, Jinkyeong
Lim, Seong Yong
Oh, Yeon-Mok
Yoo, Kwang Ha
Park, Yong Bum
Sheen, Seung Soo
Kim, Min-Ji
Carriere, K. C.
Jung, Ji Ye
Park, Hye Yun
author_sort Kim, Jung Soo
collection PubMed
description Two once-daily inhaled bronchodilators, indacaterol and tiotropium, are widely used as first-line therapy in stable COPD patients. This study was performed to compare the clinical efficacy and safety between indacaterol and tiotropium in patients with moderate-to-severe COPD. MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched to identify all published randomized controlled trials (RCTs). The primary outcome was trough forced expiratory volume in 1 second (FEV(1)) at week 12. Four RCTs were eligible for inclusion (three RCTs with moderate-to-severe COPD patients and one RCT with only severe COPD patients). Trough FEV(1) at weeks 12 and 26 were not significantly different between indacaterol and tiotropium by the standardized mean difference with 0.014 (95% CI, -0.036, 0.063, I(2)= 23.5%) and with 0.037 (95% CI, -0.059 to 0.133, I(2)= 0%) along with differences in means of 0.003L and 0.014L, respectively. Indacaterol and tiotropium also showed similar St. George`s Respiratory Questionnaire (SGRQ) total scores and percentages of patients with SGRQ improvement (≥ 4 units) at week 26. The incidences of nasopharyngitis, serious cardiovascular events, and serious adverse events were not different between indacaterol and tiotropium, while those of cough (OR = 1.68, P < 0.001, and RR = 1.63) and COPD worsening (OR = 1.18, P = 0.003, and RR = 1.12) were higher for indacaterol than tiotropium. However, when one study with only severe COPD patients was removed from the meta-analysis, the difference in the incidence of COPD worsening between indacaterol and tiotropium became non-significant (OR = 1.13, P = 0.204, and RR = 1.09). The clinical efficacy and serious adverse events between indacaterol and tiotropium were equivocal in patients with moderate-to-severe COPD. Cough is a common complaint associated with indacaterol, and COPD worsening needs to be carefully monitored in severe COPD patients when treated with indacaterol.
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spelling pubmed-43707112015-04-04 Comparison of Clinical Efficacy and Safety between Indacaterol and Tiotropium in COPD: Meta-Analysis of Randomized Controlled Trials Kim, Jung Soo Park, Jinkyeong Lim, Seong Yong Oh, Yeon-Mok Yoo, Kwang Ha Park, Yong Bum Sheen, Seung Soo Kim, Min-Ji Carriere, K. C. Jung, Ji Ye Park, Hye Yun PLoS One Research Article Two once-daily inhaled bronchodilators, indacaterol and tiotropium, are widely used as first-line therapy in stable COPD patients. This study was performed to compare the clinical efficacy and safety between indacaterol and tiotropium in patients with moderate-to-severe COPD. MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched to identify all published randomized controlled trials (RCTs). The primary outcome was trough forced expiratory volume in 1 second (FEV(1)) at week 12. Four RCTs were eligible for inclusion (three RCTs with moderate-to-severe COPD patients and one RCT with only severe COPD patients). Trough FEV(1) at weeks 12 and 26 were not significantly different between indacaterol and tiotropium by the standardized mean difference with 0.014 (95% CI, -0.036, 0.063, I(2)= 23.5%) and with 0.037 (95% CI, -0.059 to 0.133, I(2)= 0%) along with differences in means of 0.003L and 0.014L, respectively. Indacaterol and tiotropium also showed similar St. George`s Respiratory Questionnaire (SGRQ) total scores and percentages of patients with SGRQ improvement (≥ 4 units) at week 26. The incidences of nasopharyngitis, serious cardiovascular events, and serious adverse events were not different between indacaterol and tiotropium, while those of cough (OR = 1.68, P < 0.001, and RR = 1.63) and COPD worsening (OR = 1.18, P = 0.003, and RR = 1.12) were higher for indacaterol than tiotropium. However, when one study with only severe COPD patients was removed from the meta-analysis, the difference in the incidence of COPD worsening between indacaterol and tiotropium became non-significant (OR = 1.13, P = 0.204, and RR = 1.09). The clinical efficacy and serious adverse events between indacaterol and tiotropium were equivocal in patients with moderate-to-severe COPD. Cough is a common complaint associated with indacaterol, and COPD worsening needs to be carefully monitored in severe COPD patients when treated with indacaterol. Public Library of Science 2015-03-23 /pmc/articles/PMC4370711/ /pubmed/25799171 http://dx.doi.org/10.1371/journal.pone.0119948 Text en © 2015 Kim et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Kim, Jung Soo
Park, Jinkyeong
Lim, Seong Yong
Oh, Yeon-Mok
Yoo, Kwang Ha
Park, Yong Bum
Sheen, Seung Soo
Kim, Min-Ji
Carriere, K. C.
Jung, Ji Ye
Park, Hye Yun
Comparison of Clinical Efficacy and Safety between Indacaterol and Tiotropium in COPD: Meta-Analysis of Randomized Controlled Trials
title Comparison of Clinical Efficacy and Safety between Indacaterol and Tiotropium in COPD: Meta-Analysis of Randomized Controlled Trials
title_full Comparison of Clinical Efficacy and Safety between Indacaterol and Tiotropium in COPD: Meta-Analysis of Randomized Controlled Trials
title_fullStr Comparison of Clinical Efficacy and Safety between Indacaterol and Tiotropium in COPD: Meta-Analysis of Randomized Controlled Trials
title_full_unstemmed Comparison of Clinical Efficacy and Safety between Indacaterol and Tiotropium in COPD: Meta-Analysis of Randomized Controlled Trials
title_short Comparison of Clinical Efficacy and Safety between Indacaterol and Tiotropium in COPD: Meta-Analysis of Randomized Controlled Trials
title_sort comparison of clinical efficacy and safety between indacaterol and tiotropium in copd: meta-analysis of randomized controlled trials
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370711/
https://www.ncbi.nlm.nih.gov/pubmed/25799171
http://dx.doi.org/10.1371/journal.pone.0119948
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