Role of indacaterol in the management of asthma and chronic obstructive pulmonary disease

Indacaterol is the first of a new category of inhaled β2-agonists with a very long duration of action that allows for once-daily administration. The bronchodilation induced by indacaterol is more persistent than that caused by the current long-acting β2-agonists (LABAs; salmeterol and formoterol), and therefore, for this new compound, the word ‘ultra-LABA’ has been created. Indacaterol is an agonist with high intrinsic efficacy and a rapid onset (bronchodilation may reach a maximum after 5–30 min) similar to salbutamol and formoterol, but with a longer duration of action. The long-lasting bronchodilation up to 24 h has been largely demonstrated in several single-dose or short-term treatment studies with different doses of indacaterol. The increase in the forced expiratory volume in 1 s measured 24 h after indacaterol administration may reach up to 300 ml in asthma and 200 ml in chronic obstructive pulmonary disease (COPD). This long-lasting stabilization of the airway caliber may potentially translate int...