Effect of salmeterol/fluticasone propionate combination on airway hyper-responsiveness in patients with well-controlled asthma

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Abstract

Background: The hypothesis that regular treatment aimed at achieving and maintaining asthma control is accompanied by reduced airway hyper-responsiveness (AHR) was investigated. Methods: Adult patients (PC20 methacholine <8 mg/ml, FEV1% predicted ≥70%) received salmeterol/fluticasone propionate combination 50/250 μg bd (SFC250) for a 12-week run-in; those achieving well-controlled (WC) asthma were randomised to SFC250 (n = 88) or SFC50/500 μg bd (SFC500) (n = 90) for 24 weeks. AHR (PC20 methacholine), asthma control, lung function, symptoms, exacerbations and safety were assessed. Results: During the 12 week run-in (SFC250), a greater than 1 doubling dose increase in PC20 was observed. During randomised treatment, the increase in AHR was similar, and less than 1 doubling dose, for both groups (adjusted geometric mean PC20 (mg/mL) at 24 weeks: SFC250: 2.796, SFC500: 2.802; p = 0.992). Compared with SFC250, patients receiving SFC500 had a more rapid improvement in AHR (adjusted mean ratio to baseline respectively at week 4: 1.193 vs. 1.386; week 12: 1.395 vs. 1.672; p = non-significant for both) and showed a greater response to treatment in patients with a low baseline PC20. Patients maintaining WC asthma were 72 (84%) and 64 (74%) in the SFC250 and SFC500 groups respectively. Both doses of SFC were well tolerated; only four exacerbations were reported, all in the SFC500 group. Conclusion: Regular treatment with SFC resulted in continuous improvement in AHR with maintenance of asthma control in the majority of patients. SFC500 showed a trend for a more rapid improvement in AHR and resulted in greater improvements in patients with a lower baseline PC20. © 2010 Elsevier Ltd. All rights reserved.

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Chanez, P., Stallaert, R., Reznikova, E., Bloemen, P., Adamek, L., & Joos, G. (2010). Effect of salmeterol/fluticasone propionate combination on airway hyper-responsiveness in patients with well-controlled asthma. Respiratory Medicine, 104(8), 1101–1109. https://doi.org/10.1016/j.rmed.2010.04.001

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