Effect of Long-Term Salmeterol Treatment on Exercise-Induced Asthma

Nelson, Ann Jo; Strauss, Louise; Skowronski, Mary; Ciufo, R.; Novak, Ronald D.; Fadden, E. R. Mc

doi:10.1097/00132586-199906000-00064

Cited by 30 publications

(45 citation statements)

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“…Of interest, we did not observe a significant genotype-specific difference in p.m. PEF or in some of the other outcomes. This may relate to the sample size or to changes in duration of salmeterol effect with continued use (34).…”

Section: Discussionmentioning

confidence: 99%

β-Adrenergic Receptor Polymorphisms and Response to Salmeterol

Wechsler

Lehman

Lazarus

et al. 2006

Am J Respir Crit Care Med

282

147

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Rationale: Several studies suggest that patients with asthma who are homozygous for arginine at the 16th position of the ␤ 2 -adrenergic receptor may not benefit from short-acting ␤-agonists. Objectives: We investigated whether such genotype-specific effects occur when patients are treated with long-acting ␤-agonists and whether such effects are modified by concurrent inhaled corticosteroid (ICS) use. Methods: We compared salmeterol response in patients with asthma homozygous for arginine at B16 (B16Arg/Arg) with those homozygous for glycine at B16 (B16Gly/Gly) in two separate cohorts. In the first, subjects were randomized to regular therapy with salmeterol while simultaneously discontinuing ICS therapy. In the second, subjects were randomized to regular therapy with salmeterol while continuing concomitant ICS. Results: In both trials, B16Arg/Arg subjects did not benefit compared with B16Gly/Gly subjects after salmeterol was initiated. In the first cohort, compared with placebo, the addition of salmeterol was associated with a 51.4 L/min lower A.M. peak expiratory flow (PEF; p ϭ 0.005) in B16Arg/Arg subjects(salmeterol, n ϭ 12; placebo, n ϭ 5) as compared with B16Gly/Gly subjects (salmeterol, n ϭ 13; placebo, n ϭ 13). In the second cohort, B16Arg/Arg subjects treated with salmeterol and ICS concurrently (n ϭ 8

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Section: Discussionmentioning

confidence: 99%

β-Adrenergic Receptor Polymorphisms and Response to Salmeterol

Wechsler

Lehman

Lazarus

et al. 2006

Am J Respir Crit Care Med

282

147

View full text Add to dashboard Cite

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“…Furthermore, Russell et al 5 showed no loss of benefit in their parallel group study over a 12 week period and Verberne et al 9 showed no deterioration in bronchoprotection with salmeterol treatment over a four month period in 30 children with mild asthma. A more recent study 10 did show a reduction in the duration of the protective action of salmeterol against exercise induced bronchoconstriction. The short duration of the study means that we were precluded from detecting any eVect (positive or negative) on acute exacerbations of asthma.…”

Section: Discussionmentioning

confidence: 87%

Salmeterol in paediatric asthma

Byrnes

Shrewsbury

Barnes

et al. 2000

Thorax

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Background-The addition of long acting inhaled 2 agonists is recommended at step 3 of the British guidelines on asthma management but a recent study suggested no additional benefit in children with asthma. Methods-The aim of this study was to compare, in a double blind, three way, crossover study, the eVects of the addition of salmeterol 50 µg bd, salmeterol 100 µg bd, and salbutamol 200 µg qds in asthmatic children who were symptomatic despite treatment with inhaled corticosteroids in a dose of at least 400 µg/day over a one month period. Symptom scores, morning and evening peak expiratory flow (PEF) rates, use of rescue medication, spirometric indices, and histamine challenge were measured. Results-Forty five children aged 5-14 years were enrolled. All three treatments improved asthma control, morning and evening PEF rates, and spirometric indices with no change in bronchial hyperreactivity. Mean morning PEF was significantly better during the salmeterol treatment periods than with salbutamol treatment (p<0.05). The analysis of mean morning PEF gave an estimated treatment diVerence of 9.6 l/min for salmeterol 50 µg bd versus salbutamol 200 µg qds (95% confidence interval (CI) 2.1 to 17.1), and an estimated treatment diVerence of 13.8 l/min for salmeterol 100 µg bd versus salbutamol 200 µg qds (95% CI 6.0 to 21.5). There were no significant diVerences between the two doses of salmeterol and all treatments were well tolerated. Conclusions-In this population of moderate to severe asthmatic children on inhaled corticosteroids, salmeterol in a dose of either 50 µg bd or 100 µg bd is significantly more eVective at increasing the morning PEF rate over a one month period than salbutamol 200 µg qds. The data provided no significant evidence of a diVerence in eYcacy between the two doses of salmeterol, 50 µg and 100 µg. A trial of salmeterol 100 µg bd may be worth considering in those still symptomatic on the lower dose. (Thorax 2000;55:780-784)

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“…While regular use has not been found to cause substantial tachyphylaxis in duration of action, it does somewhat diminish the bronchoprotective effect. 73,74 Concerns about the safety of LABAs arose after reports of more severe exacerbations and deaths, in both adults and pediatrics, when LABA was added to usual asthma therapy. 75 This prompted the FDA to review these medications and add a new warning label that strongly suggests that LABAs should never be used as monotherapy for long-term control of persistent asthma.…”

Section: Controller Medicationsmentioning

confidence: 99%

Asthma: 2015 and Beyond

Myers

Tomasio

2011

Respir Care

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SummaryAsthma is a multifactorial, chronic inflammatory disease of the airways. The knowledge that asthma is an inflammatory disorder has become a core fundamental in the definition of asthma. Asthma's chief features include a variable degree of air-flow obstruction and bronchial hyper-responsiveness, in addition to the underlying chronic airways inflammation. This underlying chronic airway inflammation substantially contributes to airway hyper-responsiveness, air-flow limitation, respiratory symptoms, and disease chronicity. However, this underlying chronic airway inflammation has implications for the diagnosis, management, and potential prevention of the disease. This review for the respiratory therapy community summarizes these developments as well as providing an update on asthma epidemiology, natural history, cause, and pathogenesis. This paper also provides an overview on appropriate diagnostic and monitoring strategies for asthma, pharmacology, and newer therapies for the future as well as relevant management of acute and ambulatory asthma, and a brief review of educational approaches.

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Effect of Long-Term Salmeterol Treatment on Exercise-Induced Asthma

Cited by 30 publications

References 0 publications

β-Adrenergic Receptor Polymorphisms and Response to Salmeterol

β-Adrenergic Receptor Polymorphisms and Response to Salmeterol

Salmeterol in paediatric asthma

Asthma: 2015 and Beyond

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