Data from: Once-daily long-acting beta-agonists for chronic obstructive pulmonary disease: an indirect comparison of olodaterol and indacaterol

Purpose: In the absence of head-to-head clinical trials comparing the
once-daily, long-acting beta2-agonists olodaterol and indacaterol for the
treatment of chronic obstructive pulmonary disease (COPD), an indirect
treatment comparison by systematic review and synthesis of the available
clinical evidence was conducted. Methods: A systematic literature review
of randomized, controlled clinical trials in patients with COPD was
performed to evaluate the efficacy and safety of olodaterol and
indacaterol. Network meta-analysis and adjusted indirect comparison
methods were employed to evaluate treatment efficacy, using outcomes based
on trough forced expiratory volume in 1 second (FEV1), Transition Dyspnea
Index, St George’s Respiratory Questionnaire total score and response,
rescue medication use, and proportion of patients with exacerbations.
Results: Eighteen trials were identified for meta-analysis (eight,
olodaterol; ten, indacaterol). Olodaterol trials included patients of all
severities, whilst indacaterol trials excluded patients with very severe
COPD. Concomitant maintenance bronchodilator use was allowed in most
olodaterol trials, but not in indacaterol trials. When similarly designed
trials/data were analyzed for change from baseline in trough FEV1
(liters), the following mean differences (95% confidence interval) were
observed: trials excluding concomitant bronchodilator: indacaterol 75 mcg
versus olodaterol 5 mcg, –0.005 (–0.077 to 0.067), and indacaterol 150 mcg
versus olodaterol 5 mcg, 0.020 (–0.036 to 0.077); trials with concomitant
tiotropium: indacaterol 150 mcg versus olodaterol 5 mcg, 0.000 (–0.043 to
0.042). In sensitivity analyses of the full network, results for change
from baseline in trough FEV1 favored indacaterol, but this dataset
suffered from trial design heterogeneity. For the other endpoints
investigated, no statistically significant differences were found when
analyzed in the full network. Conclusion: When compared under similar
trial conditions, olodaterol and indacaterol have similar efficacy in
patients with COPD. This research highlights the importance of considering
the concomitant COPD medication when evaluating treatment effects in COPD.