Houghton CM, Lawson N, Borrill ZL, Wixon CL, Yoxall SQ, Langley SJ, Woodcock AA, Singh D
Comparison of the effects of salmeterol/fluticasone propionate with fluticasone propionate on airway physiology in adults with mild persistent asthma. [JOURNAL ARTICLE]
Respir Res 2007 Jul 14; 8(1):52.
ABSTRACT:
BACKGROUND: This study compared the effect of inhaled fluticasone propionate (FP) with the combination of salmeterol/fluticasone propionate (SFC) on lung function parameters in patients with mild asthma.
METHODS: Adult patients with mild persistent asthma (greater than or equal to 80% predicted FEV1) receiving 200-500mcg of BDP or equivalent were randomised to receive either FP 100mcg or SFC 50/100mcg twice daily from a DiskusO inhaler for four weeks. The primary outcome was the change from baseline in airway resistance (sRaw) at 12 hrs post dose measured by whole body plethysmography. Impulse oscillometry and spirometry were also performed.
RESULTS: A comparison of the geometric mean sRaw at 12 hrs post dose in the SFC group to the FP group gave a ratio of 0.76 (0.66 - 0.89, p<0.001) at week 2 and 0.81 (0.71 - 0.94, p=0.006) at week 4. Similarly, significant results in favour of SFC for oscillometry measurements of resistance and reactance were observed. FEV1 was also significantly superior at week 2 in the SFC group (mean difference 0.16L, 95% CI; 0.03 - 0.28, p = 0.015), but not at week 4 (mean difference 0.17L, 95% CI -0.01 - 0.34, p = 0.060).
CONCLUSION: SFC is superior to FP in reducing airway resistance in mild asthmatics with near normal FEV1 values. This study provides evidence that changes in pulmonary function in patients with mild asthma are detected more sensitively by plethysmography compared to spirometry Trial registration number: NCT00370591.
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