0
Correspondence |

Efficacy and Safety of Indacaterol and Glycopyrronium in COPDQVA149 in COPD: An Update FREE TO VIEW

Gustavo J. Rodrigo, MD; Vicente Plaza, MD, PhD
Author and Funding Information

From the Departamento de Emergencia (Dr Rodrigo), Hospital Central de las Fuerzas Armadas; and Servei de Pneumologia (Dr Plaza), Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona.

CORRESPONDENCE TO: Gustavo J. Rodrigo, MD, Departamento de Emergencia, Hospital Central de las Fuerzas Armadas, Av 8 de Octubre 3020, Montevideo 11600, Uruguay; e-mail: gustavo.javier.rodrigo@gmail.com


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST the following conflicts of interest: Dr Rodrigo has participated as a lecturer, speaker, and advisor in scientific meetings and courses under the sponsorship of Air Products and Chemicals Inc; Almirall, SA; AstraZeneca; Boehringer Ingelheim GmbH; Dr Esteve, SA; GlaxoSmithKline; Merck Sharp & Dohme Corp; and Novartis AG. Dr Plaza has participated as a lecturer and speaker in scientific meetings and courses under the sponsorship of AstraZeneca; GlaxoSmithKline; Dr Esteve, SA; and Merck Sharp & Dohme Corp.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(2):e75. doi:10.1378/chest.14-0850
Text Size: A A A
Published online
To the Editor:

Our systematic review on the efficacy and safety of a fixed-dose combination of indacaterol and glycopyrronium (QVA149) for the treatment of COPD is publishing in this issue of CHEST (see page 309).1 In this study, we assessed this combination with its monocomponents (glycopyrronium and indacaterol) and tiotropium for the treatment of moderate to severe COPD. The results showed a superiority of inhaled QVA149 in terms of efficacy compared with glycopyrronium and with the current standard of care tiotropium. However, it was not possible to perform a pooled analysis of data comparing QVA149 vs indacaterol because we found only one trial with this comparison.2 Interestingly, a few days after our article published Online First, a new study evaluating the efficacy and safety of QVA149 against indacaterol alone was published.3 Because this study met all the inclusion criteria of our review, its data could be analyzed together with the only study that we found2 and, thereby, expand the results. The studies together included a total of 1,399 patients with moderate to severe COPD with a treatment duration of 24 weeks2 and 12 weeks.3 Data from both trials indicated that QVA149 was associated with a significant increase in trough FEV1 at day 1 (mean difference, 0.08 L; 95% CI, 0.04-0.12 L; P = .0001; I2 = 0%) and at week 12 (mean difference, 0.08 L; 95% CI, 0.04-0.12 L; P = .0001; I2 = 0%) compared with indacaterol monotherapy. Additionally, the combination showed an 11% greater likelihood of experiencing a minimal clinically important difference in transitional dyspnea index (≥ 1 point) with a number needed to benefit of 11. Although a higher percentage of patients taking QVA149 achieved a minimal clinically important difference in St. George’s Respiratory Questionnaire score (≥ 4 units of total score) vs patients taking indacaterol alone, the difference was not statistically significant (relative risk, 1.07; 95% CI, 0.98-1.17; P = .15; I2 = 55%). Finally, the overall incidence of adverse events was similar across both treatment groups. Thus, this update of our review confirms the benefits and safety of combined bronchodilator therapy compared not only with glycopyrronium or tiotropium monotherapy but also with indacaterol.

References

Rodrigo GJ, Plaza V. Efficacy and safety of a fixed-dose combination of indacaterol and glycopyrronium for the treatment of COPD: a systematic review. Chest. 2014;146(2):309-317.
 
Bateman ED, Ferguson GT, Barnes N, et al. Dual bronchodilation with QVA149 versus single bronchodilator therapy: the SHINE study. Eur Respir J. 2013;42(6):1484-1494. [CrossRef] [PubMed]
 
Vincken W, Aumann J, Chen H, Henley M, McBryan D, Goyal P. Efficacy and safety of coadministration of once-daily indacaterol and glycopyrronium versus indacaterol alone in COPD patients: the GLOW6 study. Int J Chron Obstruct Pulmon Dis. 2014;2014(9):215-228. [CrossRef]
 

Figures

Tables

References

Rodrigo GJ, Plaza V. Efficacy and safety of a fixed-dose combination of indacaterol and glycopyrronium for the treatment of COPD: a systematic review. Chest. 2014;146(2):309-317.
 
Bateman ED, Ferguson GT, Barnes N, et al. Dual bronchodilation with QVA149 versus single bronchodilator therapy: the SHINE study. Eur Respir J. 2013;42(6):1484-1494. [CrossRef] [PubMed]
 
Vincken W, Aumann J, Chen H, Henley M, McBryan D, Goyal P. Efficacy and safety of coadministration of once-daily indacaterol and glycopyrronium versus indacaterol alone in COPD patients: the GLOW6 study. Int J Chron Obstruct Pulmon Dis. 2014;2014(9):215-228. [CrossRef]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543