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Comparison of inhaled salmeterol and oral zafirlukast in asthmatic patients using concomitant inhaled corticosteroids.

Abstract

CONTEXT

For asthmatic patients who remain symptomatic on inhaled corticosteroids, augmenting the therapy with additional long-term control medication is advocated. Long-acting beta2-adrenergic agonists and leukotriene modifiers are 2 therapeutic alternatives in the long-term controller class.

OBJECTIVE

To compare the addition of a long-acting beta2-adrenergic agonist to the addition of an oral leukotriene modifier for asthma therapy in patients who remain symptomatic on inhaled corticosteroids.

DESIGN

Double-blind, double-dummy, parallel-group, multicenter clinical studies.

SETTING

54 outpatient clinical centers.

PATIENTS

429 male and female patients with asthma 12 years of age and older who were symptomatic while taking inhaled corticosteroids.

INTERVENTIONS

Salmeterol xinafoate 42 mcg via metered dose inhaler twice daily or oral zafirlukast 20 mg twice daily.

MAIN OUTCOME MEASURES

Pulmonary function, asthma symptoms, supplemental albuterol use, asthma quality of life scores, and adverse events.

RESULTS

Inhaled salmeterol provided significantly greater improvement in pulmonary function as well as significantly greater relief of both daytime and nighttime asthma symptoms compared with oral zafirlukast in patients concurrently treated with inhaled corticosteroids. The use of supplemental albuterol was reduced to a greater extent with salmeterol compared with zafirlukast. Patients treated with salmeterol showed significantly greater improvement in Asthma Quality of Life Questionnaire (AQLQ) scores and were satisfied with how fast, how long, and how well the medication worked compared with patients in the zafirlukast group. Both treatments were well tolerated and demonstrated similar safety profiles.

CONCLUSIONS

In patients with moderate to severe persistent asthma not sufficiently controlled with inhaled corticosteroids alone, the combination of inhaled salmeterol and inhaled corticosteroids is superior to the combination of oral zafirlukast and inhaled corticosteroids as stepwise therapy.

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  • Authors+Show Affiliations

    ,

    Department of Medicine at the National Jewish Medical and Research Center, 1400 Jackson Street, Denver, Colorado, USA.

    , , ,

    Source

    MeSH

    Administration, Inhalation
    Administration, Oral
    Adrenergic beta-Agonists
    Adult
    Albuterol
    Anti-Asthmatic Agents
    Asthma
    Female
    Glucocorticoids
    Humans
    Leukotriene Antagonists
    Male
    Randomized Controlled Trials as Topic
    Salmeterol Xinafoate
    Tosyl Compounds

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    11549982

    Citation

    Nelson, H S., et al. "Comparison of Inhaled Salmeterol and Oral Zafirlukast in Asthmatic Patients Using Concomitant Inhaled Corticosteroids." MedGenMed : Medscape General Medicine, vol. 3, no. 4, 2001, p. 3.
    Nelson HS, Nathan RA, Kalberg C, et al. Comparison of inhaled salmeterol and oral zafirlukast in asthmatic patients using concomitant inhaled corticosteroids. MedGenMed. 2001;3(4):3.
    Nelson, H. S., Nathan, R. A., Kalberg, C., Yancey, S. W., & Rickard, K. A. (2001). Comparison of inhaled salmeterol and oral zafirlukast in asthmatic patients using concomitant inhaled corticosteroids. MedGenMed : Medscape General Medicine, 3(4), p. 3.
    Nelson HS, et al. Comparison of Inhaled Salmeterol and Oral Zafirlukast in Asthmatic Patients Using Concomitant Inhaled Corticosteroids. MedGenMed. 2001 Jul 5;3(4):3. PubMed PMID: 11549982.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Comparison of inhaled salmeterol and oral zafirlukast in asthmatic patients using concomitant inhaled corticosteroids. AU - Nelson,H S, AU - Nathan,R A, AU - Kalberg,C, AU - Yancey,S W, AU - Rickard,K A, Y1 - 2001/07/05/ PY - 2001/9/11/pubmed PY - 2002/2/12/medline PY - 2001/9/11/entrez SP - 3 EP - 3 JF - MedGenMed : Medscape general medicine JO - MedGenMed VL - 3 IS - 4 N2 - CONTEXT: For asthmatic patients who remain symptomatic on inhaled corticosteroids, augmenting the therapy with additional long-term control medication is advocated. Long-acting beta2-adrenergic agonists and leukotriene modifiers are 2 therapeutic alternatives in the long-term controller class. OBJECTIVE: To compare the addition of a long-acting beta2-adrenergic agonist to the addition of an oral leukotriene modifier for asthma therapy in patients who remain symptomatic on inhaled corticosteroids. DESIGN: Double-blind, double-dummy, parallel-group, multicenter clinical studies. SETTING: 54 outpatient clinical centers. PATIENTS: 429 male and female patients with asthma 12 years of age and older who were symptomatic while taking inhaled corticosteroids. INTERVENTIONS: Salmeterol xinafoate 42 mcg via metered dose inhaler twice daily or oral zafirlukast 20 mg twice daily. MAIN OUTCOME MEASURES: Pulmonary function, asthma symptoms, supplemental albuterol use, asthma quality of life scores, and adverse events. RESULTS: Inhaled salmeterol provided significantly greater improvement in pulmonary function as well as significantly greater relief of both daytime and nighttime asthma symptoms compared with oral zafirlukast in patients concurrently treated with inhaled corticosteroids. The use of supplemental albuterol was reduced to a greater extent with salmeterol compared with zafirlukast. Patients treated with salmeterol showed significantly greater improvement in Asthma Quality of Life Questionnaire (AQLQ) scores and were satisfied with how fast, how long, and how well the medication worked compared with patients in the zafirlukast group. Both treatments were well tolerated and demonstrated similar safety profiles. CONCLUSIONS: In patients with moderate to severe persistent asthma not sufficiently controlled with inhaled corticosteroids alone, the combination of inhaled salmeterol and inhaled corticosteroids is superior to the combination of oral zafirlukast and inhaled corticosteroids as stepwise therapy. SN - 1531-0132 UR - https://www.unboundmedicine.com/medline/citation/11549982/Comparison_of_inhaled_salmeterol_and_oral_zafirlukast_in_asthmatic_patients_using_concomitant_inhaled_corticosteroids_ L2 - http://www.medscape.com/Medscape/GeneralMedicine/journal/2001/v03.n04/mgm0705.01.nels/mgm0705.01.nels-01.html DB - PRIME DP - Unbound Medicine ER -