Exacerbations of asthma in patients on salmeterol

Jenkins, Mair; Hilton, Colin J.; Kock, Joshua; Palmer, Jamie

doi:10.1016/0140-6736(91)90242-h

Cited by 11 publications

(3 citation statements)

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“…This latter finding has been supported by data from longer term studies with salmeterol where the rate of exacerbations did not increase during a year's treatment (30] and asthma control was better in patients receiving salmeterol treatment for three months than in a parallel group receiving placebo and symptomatic salbutamol [31 ]. This suggests that twice daily treatment with salmeterol will be of benefit in a wide spectrum of patients with mild to moderate asthma.…”

Section: Discussionmentioning

confidence: 73%

Salmeterol: a four week study of a long-acting beta-adrenoceptor agonist for the treatment of reversible airways disease

Dahl¹,

Earnshaw²,

Palmer³

1991

Eur Respir J

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A total of 1,068 patients, aged 18-70 yrs, with mild to moderate reversible airways disease, were recruited into a multicentre, double-blind, parallel group study in 76 European centres. Following a 2 week run-in period, the 692 patients fulfilling the entry criteria were randomized to 4 weeks treatment with either salmeterol 12.5, 50 or 100 micrograms or placebo b.d. all given by pressurized inhaler, with assessments of symptoms and ventilatory lung function prior to dosing. All three doses of salmeterol had significant efficacy, manifested by increased morning and evening peak expiratory flow rate (PEFR) (by 35-59 l.min-1 and 11-38 l.min-1, respectively), by reduced diurnal variation in PEFR, and by reduced requirement for additional bronchodilator for symptomatic relief. These effects were dose-related. Daytime asthma symptoms and nocturnal awakenings were significantly reduced by salmeterol treatment, although these reductions were not dose-related. The incidence of adverse events was low. Pharmacologically predictable events (e.g. tremor) were more frequent after treatment with 100 micrograms b.d. than with placebo. On the basis of the efficacy and side-effect information, 50 micrograms b.d. is considered to be the optimum dose for the treatment of this group of asthmatics.

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Section: Discussionmentioning

confidence: 73%

Salmeterol: a four week study of a long-acting beta-adrenoceptor agonist for the treatment of reversible airways disease

Dahl¹,

Earnshaw²,

Palmer³

1991

Eur Respir J

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“…While the use of inhaled P^^^gonists as a regular treatment of asthma has been questioned (23), it is worth noting that studies on 691 asthmatic patients treated for up to 1 year have shown that salmeteroltreated patients experienced one-third as many exacerbations as those of the control group (salbutamol as needed) and half as many exacerbations as patients receiving regular four times daily salbutamol. Furthermore, the percentage of patients who had an exacerbation when taking "high" or "medium" dose inhaled steroids (more or less than 1000 [igjd) was similar (13.5% and 12.5%, respectively) to that of those not taking corticosteroids (14 %) (17,24). A study indicates that SR-terbutaline combined with inhaled steroids is more effective than terbutaline alone (10).…”

Section: Discussionmentioning

confidence: 85%

“…A very common disorder, nocturnal asthma is poorly understood and, therefore, difficult to treat (13,21,22,25,26). The pathogenesis of nocturnal asthma is not yet clarified, but many causes have been proposed for this disease, and recent evidence suggests that circadian variations in airway caliber, bronchial hyperreactivity, and overnight falls in PEF could be largely responsible (2,4,17,22). It is clear that longacting drugs are needed that will have a significant effect in the early morning hours, i.e., the most vulnerable period for nocturnal asthma attacks.…”

Section: Discussionmentioning

confidence: 99%

Salmeterol compared with slow‐release terbutaline in nocturnal asthma A multicenter, randomized, double‐blind, double‐dummy, sequential clinical trial

Brambilla¹,

Chastang

Georges³

et al. 1994

Allergy

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The aim of the multicenter, randomized, double-blind, double-dummy, parallel-group clinical trial with a 2-week treatment period was to compare the efficacy and safety of salmeterol (50 micrograms twice daily) with slow-release (SR) terbutaline (5 mg orally, twice daily) in nocturnal asthma. A total of 159 asthmatic adults (FEV, 50-90% of predicted value; sex ratio: 0.87) with at least two nocturnal awakenings during a 7-d run-in period was included in the study. Patients were centrally randomized with a national computer network (Minitel). The main variable (number of awakening-free nights during the last week of treatment) was analyzed according to a sequential method with the one-sided triangular test. The number of awakening-free nights (+/- SD) was significantly higher in the salmeterol group: 5.3 +/- 2.4 vs 4.6 +/- 2.3 (P = 0.006). Salmeterol was significantly more effective than SR-terbutaline in the following factors: number of patients without any awakening during the last week of treatment (50% vs 27%, P = 0.003), mean morning PEF (351 +/- 109 l/min-1 vs 332 +/- 105 l/min-1, P = 0.04), PEF diurnal variation 6 +/- 10% vs 11 +/- 12%, P = 0.01), overall assessment of efficacy by the patient and the investigator (P = 0.001 and 0.005, respectively), and daily rescue salbutamol intakes (P = 0.004). In the salmeterol group, significantly fewer patients reported adverse events (16% vs 29%, P = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)

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Salmeterol Xinafoate as Maintenance Therapy Compared With Albuterol in Patients With Asthma

D’Alonzo

Nathan

Henochowicz³

et al. 1994

JAMA

133

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Exacerbations of asthma in patients on salmeterol

Cited by 11 publications

References 1 publication

Salmeterol: a four week study of a long-acting beta-adrenoceptor agonist for the treatment of reversible airways disease

Salmeterol: a four week study of a long-acting beta-adrenoceptor agonist for the treatment of reversible airways disease

Salmeterol compared with slow‐release terbutaline in nocturnal asthma A multicenter, randomized, double‐blind, double‐dummy, sequential clinical trial

Salmeterol Xinafoate as Maintenance Therapy Compared With Albuterol in Patients With Asthma

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