A Randomized, Placebo-Controlled Study To Evaluate the Role of Salmeterol in the In-Hospital Management of Asthma

Peters, Jay I.; Shelledy, David C.; Jones, Arthur; Lawson, Rob; Davis, Charles P.; LeGrand, Terry S.

doi:10.1378/chest.118.2.313

Cited by 32 publications

(10 citation statements)

References 22 publications

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“…412 Another study examined addition of salmeterol to OCS for hospitalized patients, but was not adequately powered to support a recommendation. 413 Antibiotics (not recommended)…”

Section: Ics/laba Combinationsmentioning

confidence: 99%

Entwicklung der subkutanen Allergen-Immuntherapie (Teil 2): präventive Aspekte der SCIT und Innovationen

et al. 2019

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 Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. It is defined by the history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary over time and in intensity, together with variable expiratory airflow limitation.  Recognizable clusters of demographic, clinical and/or pathophysiological characteristics are often called 'asthma phenotypes'; however, these do not correlate strongly with specific pathological processes or treatment responses.  The diagnosis of asthma should be based on the history of characteristic symptom patterns and evidence of variable airflow limitation. This should be documented from bronchodilator reversibility testing or other tests.  Asthma is usually associated with airway hyperresponsiveness and airway inflammation, but these are not necessary or sufficient to make the diagnosis.  If possible, the evidence for the diagnosis of asthma should be documented before starting controller treatment, as it is often more difficult to confirm the diagnosis afterwards.  Additional strategies may be needed to confirm the diagnosis of asthma in particular populations, including patients already on controller treatment, the elderly, and those in low-resource settings. DEFINITION OF ASTHMA Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. It is defined by the history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary over time and in intensity, together with variable expiratory airflow limitation. This definition was reached by consensus, based on consideration of the characteristics that are typical of asthma and that distinguish it from other respiratory conditions. DESCRIPTION OF ASTHMA Asthma is a common, chronic respiratory disease affecting 1-18% of the population in different countries (Appendix Chapter 1). Asthma is characterized by variable symptoms of wheeze, shortness of breath, chest tightness and/or cough, and by variable expiratory airflow limitation. Both symptoms and airflow limitation characteristically vary over time and in intensity. These variations are often triggered by factors such as exercise, allergen or irritant exposure, change in weather, or viral respiratory infections. Box 1-3. Differential diagnosis of asthma in adults, adolescents and children 6-11 years Age Condition Symptoms 6-11 years Chronic upper airway cough syndrome Sneezing, itching, blocked nose, throat-clearing Inhaled foreign body Sudden onset of symptoms, unilateral wheeze Bronchiectasis Recurrent infections, productive cough Primary ciliary dyskinesia Recurrent infections, productive cough, sinusitis Congenital heart disease Cardiac murmurs Bronchopulmonary dysplasia Pre-term delivery, symptoms since birth Cystic fibrosis Excessive cough and mucus production, gastrointestinal symptoms 12-39 years Chronic upper airway cough syndrome Sneezing, itching, blocked nose, throat-clearing Vocal cord dysfunction Dyspnea, inspiratory wheezing (strid...

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“…412 Another study examined addition of salmeterol to OCS for hospitalized patients, but was not adequately powered to support a recommendation. 413 Antibiotics (not recommended)…”

Section: Ics/laba Combinationsmentioning

confidence: 99%

Entwicklung der subkutanen Allergen-Immuntherapie (Teil 2): präventive Aspekte der SCIT und Innovationen

et al. 2019

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“…391 Another study examined addition of salmeterol to OCS for hospitalized patients, but was not adequately powered to support a recommendation. 392 …”

Section: Ics/laba Combinationsmentioning

confidence: 99%

Mortality in Asthma-Chronic Obstructive Pulmonary Disease Overlap in the United States

Kumbhare

Strange

2018

Southern Medical Journal

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“…A prospective, double-blind, randomized placebo-controlled trial was conducted to assess salmeterol's safety and efficacy as an adjunct to conventional therapy for inpatient management of acute asthma. 20 Forty-three patients who were admitted through the emergency department with an acute exacerbation of asthma were randomly assigned to either salmeterol 42 µg or two puffs of placebo every 12 hours in addition to standard therapy of albuterol, corticosteroids, and anticholinergic agents. The addition of salmeterol resulted in no clinically significant adverse effects.…”

Section: Long-acting Inhaled ␤ 2 -Agonists In the Acute Care Settingmentioning

confidence: 99%

“…The investigators concluded that adding salmeterol to conventional therapy is safe and may benefit hospitalized patients with asthma. 20 Recently, however, warnings have been issued about the potential association between salmeterol and rare, but potentially serious, respiratory adverse events in the ambulatory setting. 21 That warning was based on the finding of a large, placebo-controlled trial, started in 1996 to address U.S. Food and Drug Administration (FDA) concerns about the safety of long-acting ␤ 2 -agonists, particularly salmeterol, since it was the only available agent in this class at the time.…”

Section: Long-acting Inhaled ␤ 2 -Agonists In the Acute Care Settingmentioning

confidence: 99%

Focus on Inhaled β₂‐Agonists: Efficacy, Safety, and Patient Preference

Pleasants

2004

Pharmacotherapy

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Inhaled β2‐agonists are a standard therapy for patients with obstructive lung diseases. Clinical efficacy, safety, and patient preference are important reasons that these agents have become so widely used. In addition to significant bronchodilatory effects, β2‐agonists have potentially clinically important effects on the lungs including promotion of mucociliary clearance and effects on inflammation. Albuterol, levalbuterol, and salmeterol are the most frequently used agents in the United States. In the acute care setting, short‐acting β2‐agonists are standard therapy for obstructive lung disease whereas the use of long‐acting β2‐agonists in this setting is less clear. Potential clinical issues regarding the use of β2‐agonists in the acute care setting include type of inhalational delivery method used, such as metered‐dose inhaler versus nebulization, use of heliox instead of oxygen, safety issues, and selection of agent. The role of the more recently available β2‐agonists—levalbuterol (the R‐isomer of albuterol) and formoterol—are evolving. Levalbuterol may have clinical and economic advantages in the emergency department setting, however, additional research is necessary to validate this observation.

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A Randomized, Placebo-Controlled Study To Evaluate the Role of Salmeterol in the In-Hospital Management of Asthma

Cited by 32 publications

References 22 publications

Entwicklung der subkutanen Allergen-Immuntherapie (Teil 2): präventive Aspekte der SCIT und Innovationen

Entwicklung der subkutanen Allergen-Immuntherapie (Teil 2): präventive Aspekte der SCIT und Innovationen

Mortality in Asthma-Chronic Obstructive Pulmonary Disease Overlap in the United States

Focus on Inhaled β₂‐Agonists: Efficacy, Safety, and Patient Preference

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A Randomized, Placebo-Controlled Study To Evaluate the Role of Salmeterol in the In-Hospital Management of Asthma

Cited by 32 publications

References 22 publications

Entwicklung der subkutanen Allergen-Immuntherapie (Teil 2): präventive Aspekte der SCIT und Innovationen

Entwicklung der subkutanen Allergen-Immuntherapie (Teil 2): präventive Aspekte der SCIT und Innovationen

Mortality in Asthma-Chronic Obstructive Pulmonary Disease Overlap in the United States

Focus on Inhaled β2‐Agonists: Efficacy, Safety, and Patient Preference

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Focus on Inhaled β₂‐Agonists: Efficacy, Safety, and Patient Preference