Abstract
Introduction. Dyspnoea is a common, troublesome symptom of COPD. It is useful to know how patients (pts) with varying degrees of breathlessness respond to treatment.
Aim. We explored the effectiveness of the once-daily(od) long-acting inhaled bronchodilators indacaterol(IND) and tiotropium(TIO) in COPD pts according to baseline dyspnoea severity(median modified Medical Research Council[mMRC] score <2.0 or ≥2.0[ie less or more dyspnoea]).
Methods. Data were pooled from three randomized studies of double-blind IND 150µg od(n=745), IND 300µg od(n=849) and placebo(PBO; n=1171) and open-label(o/l) TIO 18µg od(n=411) in pts with moderate-to-severe COPD. Trough FEV1, transition dyspnoea index(TDI), St George's Respiratory Questionnaire(SGRQ) and odds ratios(OR) for clinically relevant response in TDI(≥1 point) and SGRQ(≥ −4 units) were evaluated at 6 months.
Results. In pts with mMRC <2/≥2 respectively(n=1425/1752), mean age was 63.1/63.9 years, FEV1 57.6/51.8% predicted, FEV1/FVC 53.9/51.6%. Differences vs PBO for outcomes in each subgroup are shown in table(p<0.05 vs *PBO, †TIO or ‡IND 150).
Conclusions. In pts with less severe dyspnoea(mMRC <2), IND 150, IND 300 and o/l TIO were similarly effective. In pts with more severe dyspnoea(mMRC ≥2), IND 300 was more effective than IND 150 and o/l TIO in improving dyspnoea. Increasing the IND dose to 300µg may be useful for pts with more severe dyspnoea.
- © 2012 ERS