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Inhaled salmeterol and fluticasone: a study comparing monotherapy and combination therapy in asthma.
Ann Allergy Asthma Immunol. 1999 Mar; 82(3):257-65.AA

Abstract

BACKGROUND

The current stepwise approach to pharmacotherapy in the treatment of asthma includes the initiation of an inhaled corticosteroid with the addition of a long-acting inhaled bronchodilator if low dose inhaled corticosteroid fails to control asthma symptoms.

OBJECTIVE

To determine whether initiation of salmeterol and fluticasone propionate treatment together improves asthma control greater than initiation of monotherapy with the individual agents alone with no additional safety risk in patients with asthma who had not previously been treated with inhaled corticosteroids.

METHODS

A total of 136 male and female patients at least 12 years of age with asthma [forced expiratory volume in 1 second (FEV) between 50% and 80% of predicted] were randomized to twice daily salmeterol 42 microg, fluticasone propionate 88 microg, fluticasone propionate 220 microg, salmeterol 42 microg plus fluticasone propionate 88 microg, salmeterol 42 microg plus fluticasone propionate 220 microg, or placebo for 4 weeks.

RESULTS

Patients treated with salmeterol combined with fluticasone propionate had improvements over baseline in FEV at endpoint that were at least twice as great (0.6 to 0.7 L) as improvements in patients treated with salmeterol (0.3 L) or fluticasone propionate alone (0.3 L) (P < .05). Patient-rated data (peak expiratory flow, asthma symptom scores, percent of days with no asthma symptoms) confirmed greater (P < .05) mean change from baseline improvements after combined treatment compared with fluticasone propionate alone. No clinically significant differences were noted between treatment groups in any safety measurement.

CONCLUSION

Initiation of maintenance therapy with salmeterol and fluticasone propionate in patients with asthma treated with short-acting beta2-agonists alone provides greater improvements in pulmonary function and symptom control than initiation of maintenance therapy with fluticasone propionate alone.

Authors+Show Affiliations

Colorado Allergy and Asthma Clinic, PC, Aurora 80012, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10094216

Citation

Pearlman, D S., et al. "Inhaled Salmeterol and Fluticasone: a Study Comparing Monotherapy and Combination Therapy in Asthma." Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, vol. 82, no. 3, 1999, pp. 257-65.
Pearlman DS, Stricker W, Weinstein S, et al. Inhaled salmeterol and fluticasone: a study comparing monotherapy and combination therapy in asthma. Ann Allergy Asthma Immunol. 1999;82(3):257-65.
Pearlman, D. S., Stricker, W., Weinstein, S., Gross, G., Chervinsky, P., Woodring, A., Prillaman, B., & Shah, T. (1999). Inhaled salmeterol and fluticasone: a study comparing monotherapy and combination therapy in asthma. Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, 82(3), 257-65.
Pearlman DS, et al. Inhaled Salmeterol and Fluticasone: a Study Comparing Monotherapy and Combination Therapy in Asthma. Ann Allergy Asthma Immunol. 1999;82(3):257-65. PubMed PMID: 10094216.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inhaled salmeterol and fluticasone: a study comparing monotherapy and combination therapy in asthma. AU - Pearlman,D S, AU - Stricker,W, AU - Weinstein,S, AU - Gross,G, AU - Chervinsky,P, AU - Woodring,A, AU - Prillaman,B, AU - Shah,T, PY - 1999/3/27/pubmed PY - 1999/3/27/medline PY - 1999/3/27/entrez SP - 257 EP - 65 JF - Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology JO - Ann Allergy Asthma Immunol VL - 82 IS - 3 N2 - BACKGROUND: The current stepwise approach to pharmacotherapy in the treatment of asthma includes the initiation of an inhaled corticosteroid with the addition of a long-acting inhaled bronchodilator if low dose inhaled corticosteroid fails to control asthma symptoms. OBJECTIVE: To determine whether initiation of salmeterol and fluticasone propionate treatment together improves asthma control greater than initiation of monotherapy with the individual agents alone with no additional safety risk in patients with asthma who had not previously been treated with inhaled corticosteroids. METHODS: A total of 136 male and female patients at least 12 years of age with asthma [forced expiratory volume in 1 second (FEV) between 50% and 80% of predicted] were randomized to twice daily salmeterol 42 microg, fluticasone propionate 88 microg, fluticasone propionate 220 microg, salmeterol 42 microg plus fluticasone propionate 88 microg, salmeterol 42 microg plus fluticasone propionate 220 microg, or placebo for 4 weeks. RESULTS: Patients treated with salmeterol combined with fluticasone propionate had improvements over baseline in FEV at endpoint that were at least twice as great (0.6 to 0.7 L) as improvements in patients treated with salmeterol (0.3 L) or fluticasone propionate alone (0.3 L) (P < .05). Patient-rated data (peak expiratory flow, asthma symptom scores, percent of days with no asthma symptoms) confirmed greater (P < .05) mean change from baseline improvements after combined treatment compared with fluticasone propionate alone. No clinically significant differences were noted between treatment groups in any safety measurement. CONCLUSION: Initiation of maintenance therapy with salmeterol and fluticasone propionate in patients with asthma treated with short-acting beta2-agonists alone provides greater improvements in pulmonary function and symptom control than initiation of maintenance therapy with fluticasone propionate alone. SN - 1081-1206 UR - https://www.unboundmedicine.com/medline/citation/10094216/Inhaled_salmeterol_and_fluticasone:_a_study_comparing_monotherapy_and_combination_therapy_in_asthma_ DB - PRIME DP - Unbound Medicine ER -