J Korean Med Sci.  2015 Oct;30(10):1453-1458. 10.3346/jkms.2015.30.10.1453.

Effect of Indacaterol on Cough and Phlegm in Chronic Obstructive Pulmonary Disease Patients: A Meta-Analysis of Five Randomized Controlled Trials

• Park J
• Lee JS
• Rhee C
• Oh YM

• KMID: 2344178
• DOI: http://doi.org/10.3346/jkms.2015.30.10.1453

Abstract

We investigated the effects of indacaterol on cough and phlegm in patients with stable chronic obstructive pulmonary disease (COPD). We performed a meta-analysis with five randomized controlled trials (RCTs) of indacaterol in stable COPD patients. The symptom severity was defined using the St. George's Respiratory Questionnaire (SGRQ). We analyzed patients treated with 150 microg (n = 945) and 300 microg (n = 832) out of 3,325 patients who completed the SGRQ from five RCTs. After a 12-week treatment of 150 microg indacaterol, cough improvement was reported in 36.5% (316/866) of patients treated with indacaterol vs. 32.2% (259/804) patients treated with placebo (Relative Ratio [RR], 1.13; 95% confidence interval [CI], 0.99-1.29). Phlegm improvement was reported in 31.0% (247/798) of patients treated with indacaterol vs. 30.6% (225/736) of patients treated with placebo (RR, 1.01; 95% CI, 0.87-1.18). Dyspnea improvement was reported in 39.5% (324/820) of patients treated with indacaterol vs. 31.5% (237/753) patients treated with placebo (RR, 1.33; 95% CI, 1.03-1.71; P = 0.001, I2 = 55.1%). Only dyspnea improvement was significant compared to placebo even at the 300 microg indacaterol dose. Compared to placebo, a 12-week treatment of the long-acting beta-agonist, indacaterol might not have a significant effect on cough or phlegm in stable COPD.

Keyword

Pulmonary Disease, Chronic Obstructive; Indacaterol; Procaterol; Cough; Phlegm; Dyspnea

MeSH Terms

Administration, Inhalation
Anti-Bacterial Agents/therapeutic use
Bronchodilator Agents/*therapeutic use
Cough/*drug therapy
Dyspnea/*drug therapy
Forced Expiratory Volume/drug effects
Humans
Indans/*therapeutic use
Placebos/administration & dosage
Pulmonary Disease, Chronic Obstructive/*drug therapy
Quinolones/*therapeutic use
Sputum/*drug effects
Surveys and Questionnaires
Treatment Outcome
Anti-Bacterial Agents
Bronchodilator Agents
Indans
Placebos
Quinolones

Figure

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  Fig. 1 The effect of 150 µg indacaterol on major respiratory symptoms; (A) effect on cough, (B) effect on phlegm, and (C) effect on dyspnea.

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  Fig. 2 The effect of 300 µg indacaterol on major respiratory symptoms; (A) effect on cough, (B) effect on phlegm, and (C) effect on dyspnea.

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