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Indacaterol vs tiotropium in COPD patients classified as GOLD A and B.

Abstract：

INTRODUCTION:According to current GOLD strategy, patients with COPD classified as groups A and B may be treated with inhaled bronchodilators, either long-acting β2-agonist (LABA) or long-acting muscarinic antagonist (LAMA). However, there is little guidance on which class of agent is preferred and a lack of prospective data to differentiate the two. METHODS:In this study, we performed post-hoc analyses of pooled data from two prospective, controlled clinical trials comparing the LABA indacaterol and LAMA tiotropium in 1422 patients with moderate airflow limitation and no history of exacerbations in the previous year. This population fits the definitions of GOLD A and B groups and could be further stratified by symptom severity using Baseline Dyspnea Index (i.e. modeling GOLD A or B) and inhaled corticosteroid (ICS) use at baseline. Outcomes measured after 12 weeks of treatment were lung function (forced expiratory volume in 1 s; FEV1), health status (St George's Respiratory Questionnaire; SGRQ), symptoms (Transition Dyspnea Index; TDI) and rescue medication use. RESULTS:In 'GOLD A' patients not receiving ICS, differences favored indacaterol versus tiotropium (trough FEV1 0.05 L; rescue medication use -0.41 puffs/day; TDI total score 0.94 points; SGRQ total score -3.13 units, all p < 0.01). In 'GOLD B, no ICS' patients, compared with tiotropium, indacaterol treatment increased trough FEV1 (0.055 L, p < 0.05) and permitted a larger reduction in rescue medication use (-0.81 puffs/day, p = 0.004). In all patients, and in patients not using ICS, differences favored indacaterol for all variables. CONCLUSIONS:Our findings suggest that patients in GOLD groups A and B may experience greater benefits with indacaterol than with tiotropium.

journal_name

Respir Med

journal_title

Respiratory medicine

authors

Mahler DA,Kerstjens HA,Donohue JF,Buhl R,Lawrence D,Altman P

doi

10.1016/j.rmed.2015.05.012

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

1031-9

issue

8

eissn

0954-6111

issn

1532-3064

pii

S0954-6111(15)00182-1

journal_volume

109

pub_type

杂志文章,多中心研究,随机对照试验

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