Prescrire Int. 2011 Sep;20(119):201-5.
In patients with chronic obstructive pulmonary disease (COPD), bronchodilator drugs have only modest symptomatic efficacy. There is no evidence that they slow disease progression. A short-acting beta-2 agonist such as salbutamol is the first-choice treatment, used either on demand or on a regular basis. Long-acting beta2 agonists are an option for patients with nocturnal symptoms. Indacaterol is a long-acting beta-2 agonist that is inhaled once a day. Indacaterol has not been compared with a short-acting beta-2 agonist. Clinical evaluation is based on 4 double-blind randomised placebo-controlled trials, 3 of which also included a group treated with another long-acting bronchodilator (formoterol, salmeterol or tiotropium. The symptomatic efficacy of indacaterol was only modest, and similar to that of other long-acting bronchodilators. Indacaterol has the known adverse effect profile of beta-2 agonists. Some adverse effects seem to be more frequent than with other long-acting bronchodilators, including post-inhalation cough, hyperglycaemia, respiratory tract infections, and possibly cardiac disorders. There is no evidence that once-daily inhalation has any advantages over twice-daily inhalation, even in terms of convenience. In addition, as efficacy is limited, there is a risk that patients will use the drug more frequently, resulting in additional adverse effects. The nebulizer used to inhale the powder in the capsules is similar to the one provided with Foradil (formoterol. In practice, indacaterol offers no therapeutic advantage over existing treatments for patients with COPD. It is better to use the best-documented drugs and, if necessary, to add non-drug measures. Eliminating exposure to toxic agents, especially tobacco smoke, remains the only treatment with a proven benefit on the course of COPD.
在慢性阻塞性肺疾病（COPD）患者中，支气管扩张剂的症状缓解疗效有限。没有证据表明它们能减缓疾病进展。短效β2激动剂如沙丁胺醇是首选治疗药物，可按需使用或定期使用。长效β2激动剂适用于有夜间症状的患者。茚达特罗是一种长效β2激动剂，每日吸入一次。茚达特罗尚未与短效β2激动剂进行比较。临床评估基于4项双盲随机安慰剂对照试验，其中3项试验还纳入了一组接受另一种长效支气管扩张剂（福莫特罗、沙美特罗或噻托溴铵）治疗的患者。茚达特罗的症状缓解疗效有限，与其他长效支气管扩张剂相似。茚达特罗具有β2激动剂已知的不良反应谱。一些不良反应似乎比其他长效支气管扩张剂更常见，包括吸入后咳嗽、高血糖、呼吸道感染以及可能的心脏疾病。没有证据表明每日一次吸入比每日两次吸入有任何优势，即使在便利性方面也是如此。此外，由于疗效有限，患者有可能更频繁地使用该药物，从而导致更多不良反应。用于吸入胶囊中粉末的雾化器与福莫特罗（Foradil）配备的雾化器相似。实际上，对于COPD患者，茚达特罗与现有治疗方法相比并无治疗优势。最好使用有充分文献记载的药物，必要时可增加非药物措施。避免接触有毒物质，尤其是烟草烟雾，仍然是唯一已证实对COPD病程有益的治疗方法。
