Improved Asthma Control and Fewer Exacerbations With Inhaled Salmeterol/Fluticasone Propionate Compared With Oral Montelukast in Children With Persistent Asthma: Peace (Pediatric Asthma Control Evaluation)

Máspero, Jorge; Soto-Ramos, Mario; Guerra, Frances; Chan, Robert; Sharma, Raj Kumar; Pedersen, Søren

doi:10.1378/chest.134.4_meetingabstracts.p51001

Cited by 4 publications

(1 citation statement)

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“…40 After 12 weeks of therapy, the improvement in morning PEF achieved with SFC was almost double that achieved with montelukast (45.8 vs. 28.7 L/min), a difference that was statistically significant (P Ͻ 0.001). In addition, the SFC group had significantly less asthma symptoms (P ϭ 0.013), required less rescue medication (P Ͻ 0.001), and had more weeks during which asthma was controlled (P Ͻ 0.001).…”

Section: Weeksmentioning

confidence: 82%

Using the Fluticasone Propionate and Salmeterol Combination to Achieve Guideline-Defined Asthma Control in a Wide Range of Patients

Quirce¹,

Poterre²,

Adamek³

2009

Clinical Pulmonary Medicine

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Despite the availability of effective medication, studies suggest that asthma control is inadequate in at least 55% of affected individuals. However, the recently revised Global Strategy for Asthma Management and Prevention guidelines, developed by the Global Initiative for Asthma (GINA), suggest that effective asthma control is possible in most patients, through appropriate pharmacological management involving both the physician and patient. The 2007 GINA guidelines recommend a stepwise approach to asthma management, whereby treatment is "stepped up" until control is achieved. The guidelines also recommend using an inhaled corticosteroid (ICS) combined with a long-acting ␤ 2 -agonist (LABA) in patients whose asthma is uncontrolled on current ICS treatment and in treatmentnaive patients who are very symptomatic. A wide range of patients, are therefore, appropriate candidates for combined LABA/ICS treatment. Combination therapy with salmeterol/fluticasone propionate combination (SFC) has been shown to achieve guideline-defined control more closely than fluticasone propionate (FP) alone, an increased dose of FP, or a combination of FP plus leukotriene receptor antagonist. Regular and sustained treatment with SFC controls inflammation, prevents symptoms, and significantly improves lung function compared with FP alone or FP plus leukotriene receptor antagonist. In addition, aiming for guideline-defined control of asthma symptoms can help to prevent exacerbations. This review discusses how SFC can be used to achieve guideline-defined asthma control in a wide range of patients and presents the clinical evidence to support this. Strategies are discussed for stepping down SFC once control is achieved, which is a further key recommendation from the GINA guidelines.

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Section: Weeksmentioning

confidence: 82%

Using the Fluticasone Propionate and Salmeterol Combination to Achieve Guideline-Defined Asthma Control in a Wide Range of Patients

Quirce¹,

Poterre²,

Adamek³

2009

Clinical Pulmonary Medicine

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Anti-leukotriene agents compared to inhaled corticosteroids in the management of recurrent and/or chronic asthma in adults and children

Chauhan

Ducharme

2012

Cochrane Database of Systematic Reviews

187

107

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Background Anti-leukotrienes (5-lipoxygenase inhibitors and leukotriene receptors antagonists) serve as alternative monotherapy to inhaled corticosteroids (ICS) in the management of recurrent and/or chronic asthma in adults and children. Objectives To determine the safety and efficacy of anti-leukotrienes compared to inhaled corticosteroids as monotherapy in adults and children with asthma and to provide better insight into the influence of patient and treatment characteristics on the magnitude of effects. Search methods We searched MEDLINE (1966 to Dec 2010), EMBASE (1980 to Dec 2010), CINAHL (1982 to Dec 2010), the Cochrane Airways Group trials register, and the Cochrane Central Register of Controlled Trials (Dec 2010), abstract books, and reference lists of review articles and trials. We contacted colleagues and the international headquarters of anti-leukotrienes producers. Selection criteria We included randomised trials that compared anti-leukotrienes with inhaled corticosteroids as monotherapy for a minimum period of four weeks in patients with asthma aged two years and older. Data collection and analysis Two review authors independently assessed the methodological quality of trials and extracted data. The primary outcome was the number of patients with at least one exacerbation requiring systemic corticosteroids. Secondary outcomes included patients with at least one exacerbation requiring hospital admission, lung function tests, indices of chronic asthma control, adverse effects, withdrawal rates and biological inflammatory markers. Main results Sixty-five trials met the inclusion criteria for this review. Fifty-six trials (19 paediatric trials) contributed data (representing total of 10,005 adults and 3,333 children); 21 trials were of high methodological quality; 44 were published in full-text. All trials pertained to patients with mild or moderate persistent asthma. Trial durations varied from four to 52 weeks. The median dose of inhaled corticosteroids was quite homogeneous at 200 μg/day of microfine hydrofluoroalkane-propelled beclomethasone or equivalent (HFABDP eq). Patients treated with anti-leukotrienes were more likely to suffer an exacerbation requiring systemic corticosteroids (N = 6077 participants; risk ratio (RR) 1.51, 95% confidence interval (CI) 1.17, 1.96). For every 28 (95% CI 15 to 82) patients treated with anti-leukotrienes instead of inhaled corticosteroids, there was one additional patient with an exacerbation requiring rescue systemic corticosteroids. The magnitude of effect was significantly greater in patients with moderate compared with those with mild airway obstruction (RR 2.03, 95% CI 1.41, 2.91 versus RR 1.25, 95% CI 0.97, 1.61), but was not significantly influenced by age group (children representing 23% of the weight versus adults), anti-leukotriene used, duration of intervention, methodological quality, and funding source. Significant group differences favouring inhaled corticosteroids were noted in most secondary outcomes including patients with at least one e...

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Addition to inhaled corticosteroids of long-acting beta2-agonists versus anti-leukotrienes for chronic asthma

Ducharme

Lasserson

Cates

2011

Cochrane Database of Systematic Reviews

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Improved Asthma Control and Fewer Exacerbations With Inhaled Salmeterol/Fluticasone Propionate Compared With Oral Montelukast in Children With Persistent Asthma: Peace (Pediatric Asthma Control Evaluation)

Cited by 4 publications

References 0 publications

Using the Fluticasone Propionate and Salmeterol Combination to Achieve Guideline-Defined Asthma Control in a Wide Range of Patients

Using the Fluticasone Propionate and Salmeterol Combination to Achieve Guideline-Defined Asthma Control in a Wide Range of Patients

Anti-leukotriene agents compared to inhaled corticosteroids in the management of recurrent and/or chronic asthma in adults and children

Addition to inhaled corticosteroids of long-acting beta2-agonists versus anti-leukotrienes for chronic asthma

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