Asthma and Airway Centre, University Health Network, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada.
Int J Chron Obstruct Pulmon Dis. 2012;7:145-52. doi: 10.2147/COPD.S19805. Epub 2012 Mar 5.
Long-acting bronchodilators have been shown to improve multiple clinical outcomes in chronic obstructive pulmonary disease (COPD) including lung function, symptoms, dyspnea, quality of life, and exacerbations. Indacaterol is a novel, inhaled, long-acting β2-agonist providing 24-hour bronchodilation with once-daily dosing. It is currently approved for the maintenance treatment of COPD to be administered as 150 or 300 μg once-daily doses as licensed in many countries and 75 μg as licensed in the US by means of a single-dose dry powder inhaler. The data from clinical development support a favorable safety and tolerability profile within the β2-agonist drug class, with no relevant issues identified. Current evidence indicates that indacaterol is suitable for use as first-line monotherapy in COPD patients with moderate disease (Global Initiative for Chronic Obstructive Lung Disease [GOLD] stage II) and beyond that do not require an inhaled corticosteroid (ICS) as per GOLD guidelines, or in combination with an ICS in severe or very severe patients with repeated exacerbations. Data from trials with the novel once-daily β2-agonist, indacaterol, indicate superior bronchodilation and clinical efficacy over twice-daily long-acting β2-agonists and at least equipotent bronchodilation as once-daily tiotropium. Bronchodilators are central in the symptomatic management of COPD. It is likely that once-daily dosing of a bronchodilator would be a significant convenience and probably a compliance-enhancing advantage, leading to improved overall clinical outcomes in patients with COPD.
长效支气管扩张剂已被证明可改善慢性阻塞性肺疾病（COPD）的多种临床结局，包括肺功能、症状、呼吸困难、生活质量和加重。茚达特罗是一种新型吸入长效β2-激动剂，每日一次给药可提供 24 小时支气管扩张作用。它目前已被批准用于 COPD 的维持治疗，剂量为每日一次 150 或 300μg，在许多国家获得许可，在美国则通过单剂量干粉吸入器获得许可的剂量为 75μg。临床开发数据支持其在β2-激动剂药物类别中具有良好的安全性和耐受性特征，未发现相关问题。目前的证据表明，茚达特罗适用于中重度疾病（GOLD 分期 II）的 COPD 患者作为一线单药治疗，并且符合 GOLD 指南中不要求使用吸入皮质类固醇（ICS）的患者，或者在有反复加重的重度或极重度患者中与 ICS 联合使用。新型每日一次β2-激动剂茚达特罗的试验数据表明，其支气管扩张作用和临床疗效优于每日两次的长效β2-激动剂，并且与每日一次噻托溴铵的支气管扩张作用至少相当。支气管扩张剂是 COPD 症状管理的核心。每日一次给药支气管扩张剂可能会带来显著的便利，并且可能提高依从性，从而改善 COPD 患者的整体临床结局。
