title: Indacaterol for the treatment of chronic obstructive pulmonary disease.
abstract: BACKGROUND
  The need for a rapid onset of action and a long duration of the broncholytic effect is the likely reason for the development of new long-acting β2-agonists (LABAs) that are fast acting and have true 24 h duration of action. Indacaterol is the archetype of once-daily LABAs and already marketed as a maintenance therapy in patients with moderate to severe chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  Meta-analyses of published data or pooled analyses of primary data provide good insight into the clinical role of indacaterol in COPD.
  
  
  CONCLUSIONS
  The choice of the once-daily bronchodilator to start treatment in a patient with COPD mainly depends on the outcome of interest. Indacaterol is more effective than tiotropium if we consider symptoms or health-related quality of life as the primary outcome. Moreover, in symptomatic patient indacaterol should be preferred to tiotropium because of its rapid onset of action. By contrast, tiotropium appears to be more effective than indacaterol if exacerbations are the expected primary outcome. However, as indacaterol/glycopyrronium fixed-dose combination (QVA149) shows superior efficacy compared to glycopyrronium and tiotropium in patients with moderate to severe COPD, a fundamental question regarding the use of indacaterol that requires clarification is whether it is preferable to start immediately with QVA149 rather than using indacaterol alone.
authors.affiliation: Second University of Naples, Department of Experimental Medicine , Naples , Italy.
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Matera
authors.forename: Paola
authors.initials: P
authors.lastname: Rogliani
authors.forename: Mario
authors.initials: M
authors.lastname: Cazzola
mesh_terms: D000280:Administration, Inhalation; D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004338:Drug Combinations; D006024:Glycopyrrolate / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000523:psychology; D011788:Quality of Life; D015363:Quinolones / Q000627:therapeutic use*; D012602:Scopolamine Derivatives / Q000627:therapeutic use; D000069447:Tiotropium Bromide; D016896:Treatment Outcome
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D001993:Bronchodilator Agents; D004338:Drug Combinations; D007189:Indans; D015363:Quinolones; D012602:Scopolamine Derivatives; C554862:indacaterol-glycopyrronium combination; C510790:indacaterol; D006024:Glycopyrrolate; D000069447:Tiotropium Bromide
keywords: chronic obstructive pulmonary disease; indacaterol; indacaterol/glycopyrronium fixed-dose combination; treatment