The effect of indacaterol/glycopyrronium versus tiotropium or salmeterol/fluticasone on the prevention of clinically important deterioration in COPD

International Journal of Chronic Obstructive Pulmonary Disease
Antonio R AnzuetoRobert Fogel

Abstract

Endpoints that evaluate deterioration rather than improvement of disease may have clinical utility in COPD. In this analysis, we compared the effects of different maintenance treatments on the prevention of clinically important deterioration (CID) in moderate-to-severe COPD patients. Data were analyzed from three 26-week studies comparing indacaterol/glycopyrronium (IND/GLY) with tiotropium (TIO) or salmeterol/fluticasone (SFC). Two definitions of CID were used; each was a composite of three outcome measures typically associated with COPD. Definition 1 (D1) comprised a ≥100 mL decrease in forced expiratory volume in 1 second (FEV1), a ≥4-unit increase in St George's Respiratory Questionnaire, and a moderate-to-severe COPD exacerbation. In Definition 2 (D2), a ≥1-unit decrease in transition dyspnea index replaced FEV1. Using D1, IND/GLY significantly reduced the risk of first or sustained CID versus either TIO (hazard ratio 0.72 [0.61, 0.86],P=0.0003 and 0.73 [0.61, 0.89],P=0.001) or SFC (0.67 [0.57, 0.80] and 0.63 [0.52, 0.77], bothP<0.0001). With D2, IND/GLY significantly reduced the risk of first, but not sustained, CID versus TIO (0.80 [0.64 to 0.99],P=0.0359 and 0.85 [0.66, 1.10],P=0.2208) and both first and sustained CID v...Continue Reading

Citations

Aug 26, 2017·Journal of Comparative Effectiveness Research·Mario Cazzola, Paola Rogliani
Sep 19, 2018·Respiratory Research·Miriam BarrechegurenMarc Miravitlles
Jun 4, 2020·Respiratory Research·Dave SinghMeiLan K Han
Jul 11, 2020·Respiratory Research·Klaus F RabeFernando J Martinez
Sep 5, 2020·International Journal of Chronic Obstructive Pulmonary Disease·Konstantinos KostikasJadwiga A Wedzicha
May 13, 2021·International Journal of Chronic Obstructive Pulmonary Disease·Claus F VogelmeierIsabelle H Boucot
Aug 21, 2021·European Respiratory Review : an Official Journal of the European Respiratory Society·Dave SinghFernando J Martinez

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Clinical Trials Mentioned

NCT01202188
NCT01709903
NCT01315249

Software Mentioned

LANTERN
IGNITE
ILLUMINATE

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