Effect of Salmeterol and Formoterol in Patients with Chronic Obstructive Pulmonary Disease

Cazzola, Mario; Santangelo, Giovanni; Piccolor, A.; Salzillo, Antonello; Matera, Maria Gabriella; D’Amato, Gennaro; Rossi, F.

doi:10.1006/pulp.1994.1012

Cited by 80 publications

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“…RABE et al [24] found that 12 µg formoterol and 50 µg of salmeterol were equally effective in mild asthmatics in protecting against methacholineinduced bronchoconstriction for up to 24 h. In a study by ZELLWEGER et al [25], 50 µg salmeterol and 24 µg formoterol produced comparable protection against methacholine-induced bronchoconstriction during at least 16 h. CAZZOLA et al [14] compared the effects of 50 µg salmeterol and 24 µg formoterol in 16 patients with COPD and concluded that both compounds were equivalent in terms of maximum bronchodilation and duration of action. However, in a second study in patients with COPD, the same authors [15] concluded that 50 µg salmeterol had a longer duration of action than 12 or 24 µg formoterol.…”

Section: Discussionmentioning

confidence: 99%

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Salmeterol versus formoterol in patients with moderately severe asthma: onset and duration of action

Noord¹,

Smeets²,

Raaijmakers³

et al. 1996

Eur Respir J

191

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We evaluated the profile of the bronchodilatory effect of three inhaled β 2 -agonists, 24 µg formoterol, 50 µg salmeterol and 200 µg salbutamol, in patients with stable, moderately severe asthma.Thirty asthmatics (mean±SD age 54±8 yrs; forced expiratory volume in one second (FEV1) 58±12% predicted; reversibility of FEV1 21±8% from baseline) participated in a single-centre, double-blind, randomized, single-dose, cross-over study. FEV1 was obtained in baseline condition and 10, 20, 30, 60 min, and every hour up to 12 h after inhalation of the trial drug. Specific airway conductance (sGaw) was measured at baseline condition and 1, 3, 5, 7, 10, 20, 30, 60 min, and every hour up to 12 h after inhalation.Formoterol produced a mean increase in sGaw (as % of baseline) of 44% after 1 min, maximal (135%) after 2 h, and 56% after 12 h. The mean increase in FEV1 was maximal (27%) after 2h, and 10% after 12 h. After salmeterol, mean increase in sGaw amounted to 16% after 3 min, maximal (111%) after 2-4 h, and 58% after 12 h. The mean increase in FEV1 was maximally 25% after 3h, being 11% after 12 h. After salbutamol, mean increase in sGaw was 44% after 1 min and maximal (100%) after 30 min. The peak increase in FEV1 was 25%.We conclude that formoterol (24 µg) and salmeterol (50 µg) had an equal bronchodilatory capacity, which was similar to that of 200 µg salbutamol and lasted for at least 12 h in patients with asthma. However, formoterol had a more rapid onset of action than salmeterol, equal to that of salbutamol. Eur Respir J., 1996Respir J., , 9, 1684Respir J., -1688 Formoterol and salmeterol are the first two drugs of a new generation of β 2 -agonists with prolonged effect. Both compounds, when administered as an aerosol by a metered-dose inhaler (MDI) or when inhaled as a powder, have the property of retaining a bronchodilatory effect for up to 12 h, which accounts for their use in patients with nocturnal asthma. Moreover, the long duration of action allows for a twice daily treatment frequency, for example, on arising in the morning and on going to bed at night, which could be helpful in promoting patient compliance [1][2][3][4][5][6].In vitro work and noncomparative studies on formoterol and salmeterol have shown evidence that there are small differences between the two inhaled drugs with regard to the speed of onset of a bronchodilatory effect, duration of action and dose-dependency of the duration of effect [6][7][8][9][10][11][12][13]. At the present time, a few comparative studies in patients with chronic obstructive pulmonary disease (COPD) have been published [14,15], however, a direct comparison of the profile of the bronchodilatory effect in asthma is still lacking.The purpose of the present study was to compare the onset and duration of action of 24 µg formoterol, 50 µg salmeterol and 200 µg salbutamol in patients with moderately severe asthma. Patients and methodsThirty adults with asthma, 8 females and 22 males, who met the American Thoracic Society (ATS) diagnostic criteria for asthma [16], vo...

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Section: Discussionmentioning

confidence: 99%

“…At the present time, a few comparative studies in patients with chronic obstructive pulmonary disease (COPD) have been published [14,15], however, a direct comparison of the profile of the bronchodilatory effect in asthma is still lacking.…”

mentioning

confidence: 99%

Salmeterol versus formoterol in patients with moderately severe asthma: onset and duration of action

Noord¹,

Smeets²,

Raaijmakers³

et al. 1996

Eur Respir J

191

View full text Add to dashboard Cite

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“…Each patient was requested to discontinue all bronchodilating medications starting from at least 24 h before execution of the test [12][13][14]. All subjects performed two types of manoeuvres: no.…”

Section: Methodsmentioning

confidence: 99%

Bronchodilation test in COPD: effect of inspiratory manoeuvre preceding forced expiration

et al. 2003

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The effects of an inspiratory manoeuvre preceding forced expiration on functional tests performed under routine conditions before and after inhalation of a bronchodilator drug (salbutamol) were assessed on 150 consecutive chronic obstructive pulmonary disease outpatients. The patients performed forced vital capacity manoeuvres either immediately after a rapid inspiration (manoeuvre no. 1) or after a slow inspiration with a 4-6 s pause (manoeuvre no. 2).Under baseline conditions, forced expiratory volume in one second (FEV1) values were 8% (% control) larger with manoeuvre no. 1 than no. 2. FEV1 values increased with salbutamol administration by y8% and were, on average, still 7% larger with manoeuvre no. 1 than no. 2. The incidence of reversibility, assessed according to American Thoracic Society criteria, was 76% when manoeuvre no. 2 was selected to represent baseline conditions and manoeuvre no. 1 was chosen to represent the effects of bronchodilator administration, whereas the lowest incidence (2%) was found when manoeuvre no. 1 was selected to represent baseline conditions and manoeuvre no. 2 was chosen to represent the effects of bronchodilator administration.These results indicate that the time dependence of the forced vital capacity manoeuvre has an important impact on the assessment of routine lung function in a clinical setting and supports the notion that the time course of the inspiration preceding the forced vital capacity manoeuvre should be standardised. The forced vital capacity (FVC) manoeuvre is the most common ventilatory function test in clinical practice and is used both as a screening test and as a test to diagnose and follow-up pulmonary and extrapulmonary respiratory diseases. In particular, the forced expiratory volume in one second (FEV1) is considered to be the most reproducible respiratory function test. The procedure of FVC measurement and its reproducibility have been described in detail previously [1][2][3]. In the early 1990s, D9ANGELO and coworkers [4,5] showed that FEV1, peak expiratory flow (PEF) and the forced expiratory flow at 25, 50 and 75% of FVC both in healthy subjects and in chronic obstructive pulmonary disease (COPD) patients, are affected by the speed of the inspiration and duration of the end-inspiratory pause before the forced expiration. In particular, FEV1 was found to be, on average, 5 and 8% higher in healthy subjects and COPD patients, respectively, when FVC was performed immediately after a rapid inspiration rather than a slow inspiration with an end-inspiratory pause of 4-6 s. Therefore, the suggestion was made that a more precise standardisation of the FVC manoeuvre was required.The purpose of the present study was to assess how the execution of the FVC manoeuvre could affect functional tests performed in everyday clinical practice (i.e. under routine conditions) and to verify the reproducibility of previous results obtained in a small number of COPD subjects after pharmacological bronchodilation with an inhalatory b 2 -agonist [6] on a larger COPD...

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“…In patients with asthma or COPD, the onset of bronchodilation with salmeterol is approximately 10 min, although maximal bronchodilation may not occur for hours (Tattersfield, 1993;Cazzola et al, 1994Cazzola et al, , 1995.…”

Section: Long-acting ␤ 2 -Adrenergic Receptor Agonistsmentioning

confidence: 99%

“…In patients with asthma or COPD, 460 the bronchodilation elicited by salmeterol lasts at least 12 h (van Noord et al, 1996;Cazzola et al, 1994Cazzola et al, , 1995. It is noteworthy that in patients with mild bronchial asthma, 50 g of salmeterol seems to have a duration of action up to 24 h .…”

Section: Long-acting ␤ 2 -Adrenergic Receptor Agonistsmentioning

confidence: 99%

Pharmacology and Therapeutics of Bronchodilators

et al. 2012

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Effect of Salmeterol and Formoterol in Patients with Chronic Obstructive Pulmonary Disease

Cited by 80 publications

References 0 publications

Salmeterol versus formoterol in patients with moderately severe asthma: onset and duration of action

Salmeterol versus formoterol in patients with moderately severe asthma: onset and duration of action

Bronchodilation test in COPD: effect of inspiratory manoeuvre preceding forced expiration

Pharmacology and Therapeutics of Bronchodilators

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