Effect on Airway Responsiveness of Six Weeks Treatment with Salmeterol

Beach, Jeremy; Young, Calvin; Harkawat, R; Gardiner, Philip; Avery, A J; Coward, G.A.; Walters, EH; Hendrick, D. J.

doi:10.1006/pulp.1993.1020

Cited by 25 publications

(10 citation statements)

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“…Similar data were obtained with a long-acting l3,-adrenergic agonist, salmeterol, in patients with mild asthma (12). On the other hand, no rebound increase in bronchial responsiveness was observed in asthmatic patients on stopping treatment (12)(13)(14).…”

supporting

confidence: 77%

“…The dose of formoterol used was 24 ug twice daily, which is the maximal clinical dosage recommended, in order to maximize the chance of eliciting any rebound bronchial hyperresponsiveness that has been described with cessation of short-acting 132-agonists (5,8). Rebound increase in bronchial hyperresponsiveness has not been observed in other studies after cessation of treatment with salmeterol (12)(13)(14), although in the studies of Beach and colleagues (13) and those of Booth and coworkers (13,14), the patients were also established on inhaled steroid therapy. However, a number of studies with short-acting 132-agonists have demonstrated a small increase in bronchial responsi venessof the order of 2-to 3-fold (5-9) after treatment cessation.…”

Section: Discussionmentioning

confidence: 97%

“…Our findings also agree with those of Ramage and colleagues (30), who reported reduced bronchoprotection to exercise-induced bronchoconstriction in 12 patients after 4-wk of regular salmeterol therapy. No tolerance to bronchoprotection has, however, been observed in asthmatic patients using regular salmeterol and maintained on inhaled glucocorticosteroids (13,14), although these studies have been parallel rather than cross-over in design, and individual variation may be marked. Several studies of long-acting !3,-agonists have found neither tolerance of the bronchodilator response to formoterol nor changes in the dose-response curve to salbutamol (31)(32)(33).…”

Section: Side Effectsmentioning

confidence: 96%

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Regular formoterol treatment in mild asthma. Effect on bronchial responsiveness during and after treatment.

Yates¹,

Sussman²,

Shaw³

et al. 1995

Am J Respir Crit Care Med

112

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Regular beta 2-adrenoceptor agonist therapy may lead to a rebound increase in bronchial responsiveness on discontinuation of therapy and a reduction in bronchoprotective effects. Formoterol, a long-acting beta 2-agonist, is effective in single doses in the prevention of methacholine-induced bronchoconstriction. In a double-blind, placebo-controlled cross-over study, we examined the effect of an inhaled long-acting beta 2-adrenoceptor agonist, formoterol (24 micrograms twice a day) for 2 wk on airway function and responsiveness in 17 subjects with mild asthma (mean age, 26.3 +/- 1.4 yr) who were not taking inhaled glucocorticosteroids. FEV1 and the provocative concentration of methacholine causing a 20% fall in FEV1 (PC20) were measured at 36, 60, and 108 h and at 2 wk after the last dose of regular treatment. In addition, PC20 was measured 12 h after the first and the last dose of formoterol and placebo. PC20 values at 36, 60, and 108 h and at 2 wk after formoterol treatment cessation were not significantly different from those after placebo. Mean FEV1 was 3.44 +/- 0.18 L after placebo compared with 3.79 +/- 0.20 L after formoterol (p < 0.001) 12 h after the first dose, and mean PC20 was 0.53 (GSEM 1.4) mg/ml after placebo compared with 2.0 (GSEM 1.4) mg/ml after formoterol (p < 0.001). After 2 wk of regular treatment, mean FEV1 at 12 h after the final dose of formoterol fell to 3.51 +/- 0.23 L compared with 3.41 +/- 0.18 L after the final dose of placebo (p = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)

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supporting

confidence: 77%

Section: Discussionmentioning

confidence: 97%

Section: Side Effectsmentioning

confidence: 96%

See 1 more Smart Citation

Regular formoterol treatment in mild asthma. Effect on bronchial responsiveness during and after treatment.

Yates¹,

Sussman²,

Shaw³

et al. 1995

Am J Respir Crit Care Med

112

View full text Add to dashboard Cite

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“…In this group of patients the protective effect of salmeterol seen after the first dose (0.6-1.2 doubling doses) was not significantly altered after chronic dosing. Beach et al [50] studied 20 patients, all of whom were receiving inhaled corticosteroids. Bronchial reactivity to methacholine was measured 24 and 72 h after ceasing 6 weeks of continuous treatment with salmeterol, 50 gg twice daily or salbutamol 400 kg twice daily, but without placebo control.…”

Section: Antibronchoconstrictor Tolerancementioning

confidence: 99%

Tolerance with beta 2‐adrenoceptor agonists: time for reappraisal.

Grove

Lipworth

1995

Brit J Clinical Pharma

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“…Despite these cellular and vascular effects, evidence that they are of clinical relevance is still lacking. No change in bronchial hyperresponsiveness (BHR) was reported after 6 weeks of treatment with salmeterol [5] and analysis of bronchoalveolar lavage (BAL) cell profile has not shown convincing evidence of an anti-inflammatory effect [6].…”

mentioning

confidence: 99%