title: The effect of indacaterol during an acute exacerbation of COPD.
abstract: Some clinical trials have suggested that the inhaled long-acting β2-agonists (LABAs) may be effective in the treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Since indacaterol, the first once-daily LABA to be developed for the regular treatment of COPD, exhibits fast onset of action and 24-h duration of bronchodilation, we have investigated its effects in patients with AECOPD managed in the emergency department. In a randomised controlled pilot trial, we have enrolled 29 consecutive patients with a recent (i.e., within ≤ 4 d) history of AECOPD and requiring hospitalization. All patients received a standard protocol consisting of ipratropium bromide aerosol 500 μg three times a day, intravenous methylprednisolone 20 mg twice-daily and, if indicated, oral levofloxacin 500 mg once-daily. Moreover, they were randomly allocated to one of the two 5-day treatment groups (indacaterol maleate 300 μg once-daily or salbutamol nebulizer 1250 μg three times a day). The administration of indacaterol 300 μg to patients admitted to emergency department for an AECOPD resulted in a greater improvement of pulmonary function compared with traditional therapy, without cardiovascular side effects. Our results suggest that indacaterol could be a useful option in the treatment of AECOPD. However, further larger double-blinded randomized clinical trials are needed to validate the intriguing results obtained in this setting.
authors.affiliation: Department of System Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Segreti
authors.forename: Enrica
authors.initials: E
authors.lastname: Fiori
authors.forename: Luigino
authors.initials: L
authors.lastname: Calzetta
authors.forename: Marco
authors.initials: M
authors.lastname: Sabatini
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Segreti
authors.forename: Paola
authors.initials: P
authors.lastname: Rogliani
authors.forename: Mario
authors.initials: M
authors.lastname: Cazzola
mesh_terms: D000208:Acute Disease; D000280:Administration, Inhalation; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006760:Hospitalization; D006801:Humans; D007189:Indans / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009241:Ipratropium / Q000008:administration & dosage / Q000627:therapeutic use; D064704:Levofloxacin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D009330:Nebulizers and Vaporizers; D010865:Pilot Projects; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D015363:Quinolones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D001993:Bronchodilator Agents; D007189:Indans; D015363:Quinolones; D064704:Levofloxacin; C510790:indacaterol; D009241:Ipratropium; D000420:Albuterol; D008775:Methylprednisolone
keywords: COPD; Exacerbation; Indacaterol; Salbutamol