Main Article Content

Mohd Irfan Ali Khan
Mohd Shadab
Saquib Reyaz Khan
Bharath Kumar


COPD, Indacaterol-Glycopyrronium, Salmeterol-Fluticasone, FEV1, FVC, CAT Score, Adverse Effects


Background: Chronic Obstructive Pulmonary Disease (COPD) remains a significant public health concern with multiple therapeutic options available. This study aims to compare the efficacy and safety of two long-acting bronchodilators, Indacaterol-Glycopyrronium (Group A) and Salmeterol-Fluticasone (Group B), in the management of COPD.

Methods: This was a single-center, randomized, active-controlled, open-label study conducted at the Varun Arjun Medical & Rohilkhand Hospital, Shahjahanpur, India. Sixty patients were allocated to each treatment group. Primary outcomes included changes in Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC). Secondary outcomes were changes in the COPD Assessment Test (CAT) score and the occurrence of adverse effects. The study was approved by the Institutional Review Board and followed the Helsinki Declaration guidelines.

Results: Both treatments led to statistically significant improvements in FEV1 and FVC, with p-values of 0.205 and 0.169, respectively. The CAT score also improved significantly in both groups (p=0.083). Adverse effects were minimal and comparable between the two groups.

Limitations: The study was conducted at a single center and had a relatively small sample size. The open-label design and short follow-up period of 12 weeks may also affect the generalizability of the findings.

Conclusion: Both Indacaterol-Glycopyrronium and Salmeterol-Fluticasone were effective in improving lung function parameters and the quality of life in COPD patients, with minimal adverse effects. No significant difference in efficacy or safety was noted between the two treatments. Future multi-centric trials with larger sample sizes are recommended

Abstract 175 | pdf Downloads 122


1. Wedzicha JA, Miravitlles M, Hurst JR, et al. Management of COPD exacerbations: a European Respiratory Society/American Thoracic Society guideline. Eur Respir J. 2017;49(3):1600791.
2. Bafadhel M, Peterson S, De Blas MA, et al. Predictors of exacerbation risk and response to budesonide in patients with chronic obstructive pulmonary disease: a post-hoc analysis of three randomised trials. Lancet Respir Med. 2018;6(2):117-126.
3. Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary. Am J Respir Crit Care Med. 2017;195(5):557-582.
4. Cazzola M, Molimard M. The scientific rationale for combining long-acting beta2-agonists and muscarinic antagonists in COPD. Pulm Pharmacol Ther. 2010;23(4):257-267.
5. Donohue JF, Niewoehner D, Brooks J, O'Dell D, Church A. Safety and tolerability of once-daily umeclidinium/vilanterol 125/25 mcg and umeclidinium 125 mcg in patients with chronic obstructive pulmonary disease: Results from a 52-week, randomised, double-blind, placebo-controlled study. Respir Res. 2014;15:78.
6. Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary. Am J Respir Crit Care Med. 2017;195(5):557-582.
7. Rhee CK, Yoshisue H, Lad R. Fixed-Dose Combinations of Long-Acting Bronchodilators for the Management of COPD: Global and Asian Perspectives. Adv Ther. 2019;36(3):495-519.
8. Mathioudakis AG, Vestbo J, Singh D. Long-Acting Bronchodilators for Chronic Obstructive Pulmonary Disease: Which One(S), How, and When? Clin Chest Med. 2020;41(3):463-474.
9. Kolasani BP, Mudium R, Diyya S. Indacaterol and salmeterol in COPD patients: a comparative study of efficacy and safety. Int J Basic Clin Pharmacol. 2017;2(4):421–427.
10. Jones PW, Donohue JF, Nedelman J, et al. Correlating changes in lung function with patient outcomes in chronic obstructive pulmonary disease: a pooled analysis. Respir Res. 2011;12:161.
11. Kim BG, Shin SH, Gil HI, Zo S, Im Y, Song JY, Lee CY, Kang D, Cho J, Park HY. Change in individual chronic obstructive pulmonary disease assessment test item scores after short-term bronchodilator therapy and its impact on exacerbation in treatment-naïve patients with chronic obstructive pulmonary disease. Ther Adv Chronic Dis. 2022;13:20406223221114235.
12. Jara M, Lanes SF, Wentworth C 3rd, May C, Kesten S. Comparative safety of long-acting inhaled bronchodilators: a cohort study using the UK THIN primary care database. Drug Saf. 2007;30(12):1151-60.
13. Poot CC, Meijer E, Kruis AL, Smidt N, Chavannes NH, Honkoop PJ. Integrated disease management interventions for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2021;9(9):CD009437.
14. Franssen FM, Alter P, Bar N, Benedikter BJ, Iurato S, Maier D, Maxheim M, Roessler FK, Spruit MA, Vogelmeier CF, Wouters EF, Schmeck B. Personalized medicine for patients with COPD: where are we? Int J Chron Obstruct Pulmon Dis. 2019;14:1465-1484