PMID- 24556877
OWN - NLM
STAT- MEDLINE
DCOM- 20141031
LR  - 20181202
IS  - 1931-3543 (Electronic)
IS  - 0012-3692 (Linking)
VI  - 146
IP  - 2
DP  - 2014 Aug
TI  - Efficacy and safety of a fixed-dose combination of indacaterol and Glycopyrronium 
      for the treatment of COPD: a systematic review.
PG  - 309-317
LID - S0012-3692(15)48820-8 [pii]
LID - 10.1378/chest.13-2807 [doi]
AB  - BACKGROUND: COPD guidelines recommend the combined use of inhaled, long-acting 
      beta2-agonists and long-acting muscarinic antagonists if symptoms are not improved 
      by a single agent. This systematic review assessed the efficacy and safety of the 
      fixed-dose combination of the long-acting beta2-agonist indacaterol and long-acting 
      muscarinic antagonist glycopyrronium (QVA149) compared with its monocomponents 
      (glycopyrronium and indacaterol) and tiotropium for the treatment of moderate to 
      severe COPD. METHODS: This was a systematic review of randomized, 
      placebo-controlled or crossover trials (3-64 weeks). Primary outcomes were trough 
      FEV1, severe adverse events, and serious cardiovascular events. RESULTS: Five 
      trials (4,842 patients) were included. Compared with tiotropium, QVA149 showed a 
      significant increase in trough FEV1 (70 mL; P < .0001) and a decreased use of 
      rescue medication (-0.63 puffs/d; P < .0001). Patients receiving QVA149 had a 19% 
      greater likelihood of experiencing a minimal clinical important difference (MCID) 
      in the number needed to treat for benefit (NNTB) (NNTB = 11) and a 16% greater 
      likelihood of achieving an MCID in the St. George's Respiratory Questionnaire 
      (SGRQ) (NNTB = 11). Similarly, QVA149 vs glycopyrronium showed a significant 
      increase in trough FEV1 (70 mL; P < .0001), a significant reduction in rescue 
      medication use (-0.59; P < .0001), and a significant increase in the rate of 
      patients achieving an MCID in the SGRQ (NNTB = 12). QVA149 showed similar levels 
      of safety and tolerability to both comparators. It was not possible to perform a 
      pooled analysis of data comparing QVA149 vs indacaterol. CONCLUSIONS: Once-daily, 
      inhaled QVA149 showed superior efficacy compared with glycopyrronium and the 
      current standard of care, tiotropium, in patients with moderate to severe COPD.
FAU - Rodrigo, Gustavo J
AU  - Rodrigo GJ
AD  - Departamento de Emergencia (Dr Rodrigo), Hospital Central de las Fuerzas Armadas, 
      Montevideo, Uruguay, Spain; Servei de Pneumologia (Dr Plaza), Hospital de la 
      Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain. 
      Electronic address: gustavo.javier.rodrigo@gmail.com.
FAU - Plaza, Vicente
AU  - Plaza V
AD  - Departamento de Emergencia (Dr Rodrigo), Hospital Central de las Fuerzas Armadas, 
      Montevideo, Uruguay, Spain; Servei de Pneumologia (Dr Plaza), Hospital de la 
      Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
RN  - 0 (Indans)
RN  - 0 (Muscarinic Antagonists)
RN  - 0 (Quinolones)
RN  - 8OR09251MQ (indacaterol)
RN  - V92SO9WP2I (Glycopyrrolate)
SB  - IM
MH  - Dose-Response Relationship, Drug
MH  - Drug Therapy, Combination
MH  - Glycopyrrolate/*administration & dosage
MH  - Humans
MH  - Indans/*administration & dosage
MH  - Muscarinic Antagonists/administration & dosage
MH  - Practice Guidelines as Topic
MH  - Pulmonary Disease, Chronic Obstructive/*drug therapy
MH  - Quinolones/*administration & dosage
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
EDAT- 2014/02/22 06:00
MHDA- 2014/11/02 06:00
CRDT- 2014/02/22 06:00
PHST- 2014/02/22 06:00 [entrez]
PHST- 2014/02/22 06:00 [pubmed]
PHST- 2014/11/02 06:00 [medline]
AID - S0012-3692(15)48820-8 [pii]
AID - 10.1378/chest.13-2807 [doi]
PST - ppublish
SO  - Chest. 2014 Aug;146(2):309-317. doi: 10.1378/chest.13-2807.