Indacaterol once-daily is equally effective dosed in the evening or morning in COPD

Indacaterol is a novel, inhaled, long acting beta(2) agonist providing 24 h bronchodilation with once daily (o d) dosing in patients with COPD In this double blind, incomplete block crossover study, patients with moderate to severe COPD were randomised to receive three treatment cycles from indacaterol 300 mu g o d dosed PM or AM, salmeterol 50 mu g twice daily or placebo, each for 14 days Trough FEV1 was measured 24 h after indacaterol and 12 h after salmeterol Ninety six patients (mean age 64 years, post bronchodilator FEV1 57% predicted, FEV1/FVC 55%) were randomised, 83 completed After 14 days, the difference vs placebo in trough FEV1 for PM indacaterol was 200 mL (p < 0 001 [primary analysis]) and for AM indacaterol was 200 mL (p < 0 001) Compared with salmeterol, trough FEV1 for PM indacaterol was 110 mL higher (p < 0 001), and for AM indacaterol was 50 mL higher (p = NS) Over 14 days, vs placebo, both PM and AM indacaterol improved the % of nights with no awakenings (by 11 9 and 8 1 points, p < 0 01), the % of days with no daytime symptoms (by 6 7 and 5 5 points, p < 0 05), and the % of days able to perform usual activities (by 6 7 and 7 8 points, p < 0 05) Indacaterol provided 24 h bronchodilation and improvement in symptoms regardless of whether taken regularly in the morning or evening Clinical trial registration ChnicalTrials gov NCT00615030 (C) 2010 Elsevier Ltd All rights reserved