INSTEAD: Randomized switch trial of indacaterol and salmeterol/fluticasone combination (SFC) in moderate COPD: Symptoms results

Contrary to GOLD recommendations, patients at low risk of exacerbation and moderate airflow limitation are frequently prescribed inhaled corticosteroids. 1 Recent data from INSTEAD showed that patients with moderate COPD and no exacerbations in the previous year can be switched from SFC 50/500µg BID to indacaterol 150µg with no efficacy decrease. 2 Exploratory symptom efficacy data are presented here. Methods were published previously. 2 Patients recorded morning/evening daily respiratory symptoms, cough, wheezing, sputum volume and colour, breathlessness, sore throat, cold and fever. This analysis was a prespecified exploratory objective. The percentage of nights with no night-time awakenings, days with no daytime symptoms, and days able to perform usual daily activities were calculated over 12 and 26 wks treatment, as were mean individual diary symptom scores. There were no statistically significant differences between indacaterol and SFC for any variable, illustrated in Table 1. Patients at low risk of exacerbation can be switched from SFC to indacaterol with no deterioration in symptoms or symptoms scores. Vestbo J et al Respir Med 2014;108:729-36 Rossi A et al ERJ 2014;44:1548-56