title: Effect of indacaterol on exercise endurance and lung hyperinflation in COPD.
abstract: BACKGROUND
  Indacaterol is a novel, inhaled, once-daily ultra long-acting β(2)-agonist (ultra-LABA) for the treatment of COPD. This study investigated the effect of indacaterol on exercise endurance, and on lung hyperinflation during exercise and at rest in patients with moderate-to-severe COPD.
  
  
  METHODS
  In this double-blind, placebo-controlled, two-period crossover study (3-week treatment, 3-week washout between treatments), patients were randomized to receive indacaterol 300 μg once-daily or matching placebo. The primary efficacy variable was exercise endurance time after 3 weeks of treatment, measured through constant-load cycle ergometry testing performed at 75% of the peak work rate in a screening incremental exercise test.
  
  
  RESULTS
  Of 90 patients randomized (mean age: 62.8 years; post-bronchodilator FEV(1): 61.2% predicted and FEV(1)/FVC: 51.6%), 74 completed the study. Pre-treatment exercise tolerance averaged 459 s. Improvement in exercise endurance time was higher with indacaterol 300 μg than with placebo both after the first dose (treatment difference: 101 s; p < 0.001) and after 3 weeks (treatment difference: 111 s; p = 0.011). In addition, indacaterol increased end-exercise inspiratory capacity (IC) versus placebo after 3 weeks (0.28 L, p = 0.002). Significant improvements were also observed in resting IC (0.17 L, p = 0.001), FEV(1) (0.25 L, p < 0.001) and FVC (0.26 L, p < 0.001) with indacaterol compared with placebo at 75 min post-dose after 3 weeks.
  
  
  CONCLUSIONS
  In conclusion, indacaterol treatment improved the ability of patients with COPD to exercise. In addition, the improvements observed in resting and end-exercise IC indicate reductions in lung hyperinflation after 3 weeks treatment (ClinicalTrials.gov registration number: NCT00620022).
authors.affiliation: Queen's University and Kingston General Hospital, Kingston, Ontario K7L 2V7, Canada.
authors.forename: Denis E
authors.initials: DE
authors.lastname: O'Donnell
authors.forename: Richard
authors.initials: R
authors.lastname: Casaburi
authors.forename: Walter
authors.initials: W
authors.lastname: Vincken
authors.forename: Luis
authors.initials: L
authors.lastname: Puente-Maestu
authors.forename: James
authors.initials: J
authors.lastname: Swales
authors.forename: David
authors.initials: D
authors.lastname: Lawrence
authors.forename: Benjamin
authors.initials: B
authors.lastname: Kramer
mesh_terms: D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000494:pharmacology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005080:Exercise Test; D017079:Exercise Tolerance / Q000187:drug effects; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007189:Indans / Q000008:administration & dosage* / Q000494:pharmacology; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D015363:Quinolones / Q000008:administration & dosage* / Q000494:pharmacology; D012129:Respiratory Function Tests / Q000379:methods; D012146:Rest
chemical_list: D001993:Bronchodilator Agents; D007189:Indans; D015363:Quinolones; C510790:indacaterol