Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial

Calverley, Peter M.A.; Pauwels, Romain; Vestbo, Jørgen; Jones, Paul; Pride, N. B.; Gulsvik, Amund; Anderson, Julie A.; Maden, Claire

doi:10.1016/s0140-6736(03)12459-2

Cited by 1,100 publications

(970 citation statements)

References 27 publications

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“…In effect, some papers have documented the advantage for COPD patients in combining long-acting anticholinergic and long-acting ß2-adrenergic agents [3][4][5][6]. Other papers [4][5][6][7][8][9][10][11][12][13][14][15] have clearly shown that both longacting ß2-agonists and inhaled corticosteroids have an important role in COPD, which increases when the two drugs are combined in the same therapeutic regimen.…”

Section: Introductionmentioning

confidence: 99%

A pilot study to assess the effects of combining fluticasone propionate/salmeterol and tiotropium on the airflow obstruction of patients with severe-to-very severe COPD

Cazzola

Andò

Santus

et al. 2007

Pulmonary Pharmacology & Therapeutics

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A c c e p t e d m a n u s c r i p t AbstractThe aim of this pilot study was to explore the relative efficacy in terms of improvement in symptoms and lung function of combining fluticasone propionate/salmeterol combination (FSC) and tiotropium in patients with severe-to-very severe stable COPD. Ninety patients were randomized to receive 3 months of treatment in one of three treatment groups: (1) FSC 500/50 µg Diskus, 1 inhalation twice daily + placebo Handihaler 1 inhalation once-daily daily; (2) tiotropium 18 µg Handihaler, 1 inhalation once daily + placebo Diskus, 1 inhalation twice daily; (3) FSC 500/50 µg Diskus, 1 inhalation twice daily + tiotropium 18 µg Handihaler, 1 inhalation once-daily daily. Patients attended the clinic before and after 1 month, 2 months, and 3 months of treatment for evaluations of pulmonary function, and dyspnea, which was assessed using a visual analog scale (VAS). Also the supplemental salbutamol use was measured. Eighty-one patients completed the 3-month treatment period: 26 patients receiving FSC, 26 patients receiving tiotropium, and 29 patients receiving FSC + tiotropium. Patients were withdrawn for COPD exacerbation. Improvements in trough FEV 1 with all treatments medications were observed by the first month when trough FEV 1 had improved significantly above baseline by 74 mL (p < 0.05) in the tiotropium group, by 117 mL (p < 0.05) in the FSC group and by 115 mL (p < 0.05) in FSC + tiotropium group. At the end of the study, trough FEV1 had improved significantly above baseline by141 mL (p < 0.05) in the tiotropium group, by 140 mL (p < 0.05) in the FSC group and by 186 mL (p < 0.05) in FSC + tiotropium group. The difference between FSC and tiotropium appeared to decrease, that between FSC and FSC + tiotropium appeared to increase and that between tiotropium and FSC + tiotropium remained almost similar with study duration. Our results suggest that adding FSC and tiotropium may provide benefits in symptomatic patients with severe-to-very severe stable COPD.

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Section: Introductionmentioning

confidence: 99%

A pilot study to assess the effects of combining fluticasone propionate/salmeterol and tiotropium on the airflow obstruction of patients with severe-to-very severe COPD

Cazzola

Andò

Santus

et al. 2007

Pulmonary Pharmacology & Therapeutics

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“…Some studies showed clinical benefits with ICS use in moderate to severe but not in mild COPD [33][34][35][36]. ICS use is associated with reductions in the number and severity of exacerbations experienced by patients with severe COPD [34,[36][37][38][39]. In addition, in a pooled analysis of seven randomised studies involving 5085 patients, inhaled corticosteroids reduced all-cause mortality by ∼25% relative to placebo in patients with stable COPD [40].…”

Section: Treatment Options For Copdmentioning

confidence: 99%

Effective management of COPD in primary care — the role of long-acting beta agonist/inhaled corticosteroid combination therapy

Schayck

Reid

2006

Primary Care Respiratory Journal

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Summary Chronic obstructive pulmonary disease (COPD) is the internationally preferred term for chronic, progressive lung disorders which are characterised by airflow limitation that is not fully reversible. The symptoms of COPD -including breathlessness, cough, excessive sputum production and reduced muscle tone and muscle wasting -reflect the complex pathophysiology of the disease. In order to address these symptoms, treatment regimens should take into account the multiple components that contribute to COPD. Clinical evidence has emerged indicating that, especially in patients with severe COPD, long-acting beta 2 -agonists (LABAs) and inhaled corticosteroids (ICS) result in improvements in symptoms, reduce the frequency and severity of exacerbations, and improve health-related quality of life. This review evaluates the clinical evidence for the potential of LABA/ICS treatment to address the symptoms of COPD and whether combination therapy of this nature adds significant benefit to patients.

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“…More effective symptom control and reduction in exacerbation rates is achieved by a combination of inhaled corticosteroids and longacting β 2 -agonist treatment [16,17]. In addition, patients on combined fluticasone propionate and salmeterol therapy show a survival advantage over patients using each of these drugs alone [18] and current guidelines recommend treatment with both drugs for patients with moderate to severe chronic obstructive pulmonary disease [1].…”

Section: Introductionmentioning

confidence: 99%

Fluticasone, but not salmeterol, reduces cigarette smoke-induced production of interleukin-8 in human airway smooth muscle

Oltmanns

Walters

Sukkar

et al. 2008

Pulmonary Pharmacology & Therapeutics

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Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial

Cited by 1,100 publications

References 27 publications

A pilot study to assess the effects of combining fluticasone propionate/salmeterol and tiotropium on the airflow obstruction of patients with severe-to-very severe COPD

A pilot study to assess the effects of combining fluticasone propionate/salmeterol and tiotropium on the airflow obstruction of patients with severe-to-very severe COPD

Effective management of COPD in primary care — the role of long-acting beta agonist/inhaled corticosteroid combination therapy

Fluticasone, but not salmeterol, reduces cigarette smoke-induced production of interleukin-8 in human airway smooth muscle

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