Kornmann 2011.
Methods |
Design: double‐blind, parallel, randomised, controlled trial. 26 weeks' duration. Additional inhaled bronchodilators other than albuterol were discontinued. Patients were recruited from Canada, Europe, South America, India and Taiwan Run‐in: 2 weeks |
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Participants |
Population: 1002 participants with a diagnosis of moderate to severe COPD were randomly assigned. Mean age 63 years. In the indacaterol 150 mcg, salmeterol 50 mcg and placebo arms, 45%, 46% and 40% were taking concomitant inhaled corticosteroids, respectively. Mean FEV1 was 54%, 53% and 53%, respectively Inclusion criteria: age > 40, smoking history > 20 pack‐years, FEV1/FVC < 0.7, FEV1 30% to 80% predicted post bronchodilator Exclusion criteria: respiratory tract infection or COPD exacerbation during previous 6 weeks, diagnosis of asthma, concomitant pulmonary disease, long‐term oxygen therapy, type 1 or uncontrolled type 2 diabetes, cancer with less than 5‐year survival, lung cancer, QTc abnormalities, shift workers |
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Interventions | 1. Indacaterol 150 mcg 2. Salmeterol 50 mcg 3. Placebo |
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Outcomes |
Primary endpoint: 24‐hour postdose trough FEV1 after 12 weeks. Other endpoints: SGRQ, Transitional Dyspnoea Index (TDI), symptom diaries, use of as needed salbutamol Follow‐up at day 2, weeks 4, 8, 12, 26 Values reported at baseline; additional information obtained from study authors for post‐treatment data |
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Notes | Study was supported by Novartis, and some authors were Novartis employees. Novartis directly supplied data for: Indacaterol versus placebo (number of participants experiencing at least one exacerbation); Indacaterol versus LABA (dyspnoea, number of participants experiencing at least one exacerbation). |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Participants were randomly allocated to treatment using an automated system |
Allocation concealment (selection bias) | Low risk | Allocation via automated system, double‐dummy design |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | Allocated interventions were not known by participants or personnel during the study; placebo appears adequate |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Outcome assessors were blinded to treatment allocation |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Higher dropout rates in placebo arm were largely due to withdrawal of consent or unsatisfactory therapeutic effect |
Selective reporting (reporting bias) | Low risk | All outcomes were reported, not just statistically significant outcomes |