The effect of indacaterol during an acute exacerbation of COPD

• Published in: Pulmonary pharmacology & therapeutics 2013-12, Vol.26 (6), p.630-634
• Main Authors: Segreti, Andrea, Fiori, Enrica, Calzetta, Luigino, Sabatini, Marco, Segreti, Vincenzo, Rogliani, Paola, Cazzola, Mario
• Format: Article
• Language: English
• Subjects: Acute Disease; Administration, Inhalation; Adrenergic beta-2 Receptor Agonists - administration & dosage; Adrenergic beta-2 Receptor Agonists - adverse effects; Adrenergic beta-2 Receptor Agonists - therapeutic use; Aged; Albuterol - administration & dosage; Albuterol - adverse effects; Albuterol - therapeutic use; Bronchodilator Agents - therapeutic use; COPD; Drug Therapy, Combination; Exacerbation; Hospitalization; Humans; Indacaterol; Indans - administration & dosage; Indans - adverse effects; Indans - therapeutic use; Ipratropium - administration & dosage; Ipratropium - therapeutic use; Levofloxacin - administration & dosage; Levofloxacin - therapeutic use; Male; Medical Education; Methylprednisolone - administration & dosage; Methylprednisolone - therapeutic use; Nebulizers and Vaporizers; Pilot Projects; Pulmonary Disease, Chronic Obstructive - drug therapy; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary/Respiratory; Quinolones - administration & dosage; Quinolones - adverse effects; Quinolones - therapeutic use; Salbutamol; Treatment Outcome
• ISSN: 1094-5539; 1522-9629
• DOI: 10.1016/j.pupt.2013.03.020

Abstract Some clinical trials have suggested that the inhaled long-acting β2 -agonists (LABAs) may be effective in the treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Since indacaterol, the first once-daily LABA to be developed for the regular treatment of COPD, exhibits fast onset of action and 24-h duration of bronchodilation, we have investigated its effects in patients with AECOPD managed in the emergency department. In a randomised controlled pilot trial, we have enrolled 29 consecutive patients with a recent (i.e., within ≤4 d) history of AECOPD and requiring hospitalization. All patients received a standard protocol consisting of ipratropium bromide aerosol 500 μg three times a day, intravenous methylprednisolone 20 mg twice-daily and, if indicated, oral levofloxacin 500 mg once-daily. Moreover, they were randomly allocated to one of the two 5-day treatment groups (indacaterol maleate 300 μg once-daily or salbutamol nebulizer 1250 μg three times a day). The administration of indacaterol 300 μg to patients admitted to emergency department for an AECOPD resulted in a greater improvement of pulmonary function compared with traditional therapy, without cardiovascular side effects. Our results suggest that indacaterol could be a useful option in the treatment of AECOPD. However, further larger double-blinded randomized clinical trials are needed to validate the intriguing results obtained in this setting.