Comparison of the Efficacy of Salmeterol and Formoterol in the Treatment of Patients With Severe Bronchial Asthma

Abstract

Formoterol and Salmeterol are long acting β2 agonists with duration of action greater than 12 hours making them suitable for twice daily treatment and for protection against nocturnal symptoms. MATERIALS AND METHODS PATIENTS Forty two non-smoking patients admitted in the Department of Medicine, KMCH, Katihar (29 women, 13 men, mean age 45±2; mean FEV1; 61.8% of predicted) took part in the trial. INCLUSION CRITERIA All patients were receiving treatment with dosage of at least 1500 µg of an inhaled steroid (e.g. beclomethasone dipropionate, budesonide or fluticasone propionate) or regular oral steroid. All patients had an FEV1 80% of predicted. All patients reported daily asthma symptoms and were using their rescue inhaler on most days. All patients were at step 4 or 5 of the British Thoracic Society Guidelines. EXCLUSION CRITERIA All patients who had an exacerbation of asthma requiring change in maintenance treatment, patients with history of smoking. RESULTS The morning PEF was greater in patients receiving formoterol (mean increase 14.4 L/min) or salmeterol (mean increase 14.8 L/min) compared with those receiving placebo, but there was no difference between these treatments. There was no significant treatment effects for any of the secondary outcome variables (i.e. FEV1, FVC, mean evening PEF, mean daytime symptom score or night time symptom score). CONCLUSION LONG ACTING β 2 agonists salmeterol and formoterol improve morning PEF in patients with severe asthma, but there is no significant difference in efficacy between these two drugs.