Indacaterol (Arcapta) for COPD

Indacaterol (brand name, Arcapta)  is a long-acting bronchodilator from the beta agonists (LABA) class. It is used for breathing difficulties such as wheezing, shortness of breath, coughing, and chest tightness in people with COPD. It works by relaxing and opening the lung airways, which makes breathing easier.

How does indacaterol for COPD work?

Indacaterol is a long-acting beta2-adrenergic agonist. After inhalation, it will act locally in the lungs. Its effects are due to the stimulation of an enzyme, called adenyl cyclase, that is in lung muscle cells. This enzyme helps to convert adenosine triphosphate (ATP) into cyclic adenosine monophosphate (cAMP). As the levels of cAMP increase, the muscle cells relax.

Beta2-receptors are predominant in the muscle cells of the lungs, but they are also present in the heart, which means indacaterol may have cardiac effects, such as irregular heartbeats.

Studies of indacaterol

More than 5,000 people with COPD, ages 40 or older and with a smoking history of at least 10 pack years, enrolled in six different studies in which all doses of indacaterol tested showed significantly greater 24-hour post-dose trough FEV1 compared to placebo at 12 weeks. One of the studies (NCT00624286), involving 416 COPD patients, showed that indacaterol at a dose of 150 mcg provided clinically significant and sustained bronchodilation, and reduced short-acting relief bronchodilators. In both studies that used a dose of 75 mcg, participants used less short-acting relief bronchodilators than those treated with placebo.

All six studies measured health-related quality of life, and an improvement over placebo at week 12 was reported in all.

Indications and side effects

It is not intended for use in people with asthma, as people with asthma who take LABA medicines, including indacaterol, have an increased risk of severe flares. It is not known yet whether LABA medicines increase the same risk in people with COPD.

Indacaterol comes as a powder-filled capsule to inhale once a day by mouth using a special inhaler. Indacaterol for COPD controls disease symptoms but is not a cure. It should be continued even if symptoms improve.

Most common side effects are cough, sore throat, runny nose, headache, nausea, shaking of a part of the body that one cannot control and nervousness.1

There is currently generic available for indacaterol.


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