Efficacy of Salmeterol Xinafoate in the Treatment of COPD

Mahler, Donald A.; Donohue, James F.; Barbee, Robert A.; Goldman, Michael; Gross, Nicholas J.; Wisniewski, Michael; Yancey, Steven W.; Zakes, Bradford A.; Rickard, Kathleen; Anderson, Wayne H.

doi:10.1378/chest.115.4.957

Cited by 465 publications

(339 citation statements)

References 22 publications

Supporting

Mentioning

300

Contrasting

Unclassified

Order By: Relevance

“…As the results after 50 and 75 mg of salmeterol were similar, they suggested that 50 mg was the best dose of salmeterol in these patients. It has been shown that this recommended dose of 50 mg salmeterol produces a similar [11] or even greater improvement [16] in airway obstruction than the recommended dose of 40 mg ipratropium bromide. To date, only one clinical trial has been carried out on the efficacy of combined administration of salmeterol and ipratropium in COPD.…”

Section: Discussionmentioning

confidence: 85%

“…In addition, three studies in patients with COPD over periods of 1±3 months have found that treatment with salmeterol produced an improvement in lung function and daily symptom scores and was associated with a clinically significant gain in quality of life [7±10]. Recently MAHLER et al [11], comparing inhaled salmeterol and ipratropium in patients with COPD over a 12-week period, found that salmeterol was better than ipratropium at improving lung function. To date, long-term studies on combination therapy with salmeterol and ipratropium bromide are not available.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Long-term treatment of chronic obstructive pulmonary disease with salmeterol and the additive effect of ipratropium

et al. 2000

View full text Add to dashboard Cite

The efficacy and safety of salmeterol alone was compared with the combination of salmeterol plus ipratropium and with placebo during long-term treatment in patients with stable chronic obstructive pulmonary disease. In addition, the single-dose effect in response to the first dose of treatment was studied over 12 h.The patients (n=144; age 64 7 yrs, forced expiratory volume in one second (FEV1) 44 11% pred) participated in a three-centre double-blind double-placebo parallel group study and were randomized after a run-in period of 2 weeks to receive either salmeterol 50 mg b.i.d., salmeterol 5 mg b.i.d. plus ipratropium 40 mg q.i.d. or placebo for a period of 12 weeks.The single-dose study demonstrated that salmeterol produced a significant increase in FEV1 (peak of 7% pred) and specific airway conductance (sGaw) (maximum of 60% baseline) for $12 h. The combination of salmeterol plus ipratropium elicited a greater bronchodilator response (11% and 94% increases respectively) than salmeterol alone during the first 6 h after inhalation. During treatment there were significant improvements in daytime symptom scores and morning peak expiratory flow in both the salmeterol and the salmeterol plus ipratropium groups (p<0.001), with an associated decrease in the use of rescue salbutamol. Improvements in FEV1 and sGaw were greater in the salmeterol plus ipratropium group than in the patients receiving only salmeterol. Thirty-five patients had an exacerbation; 11 (23%) in the salmeterol group (versus placebo NS), six (13%) in the salmeterol plus ipratropium group (versus placebo p<0.01) and 18 (36%) in the placebo group.In conclusion, in patients with severe stable chronic obstructive pulmonary disease, long-term treatment with either salmeterol alone or salmeterol plus ipratropium is safe and effective. There was added benefit from the combination therapy in terms of improvement in airways obstruction, but not for improvement in symptom control or need for rescue salbutamol. Eur Respir J 2000; 15: 878±885. Chronic obstructive pulmonary disease (COPD) is defined as a disease state characterized by the presence of airflow obstruction, due to chronic bronchitis or emphysema, and is generally progressive but may be partially reversible [1]. The goals of pharmacotherapy in this disorder are to induce bronchodilation and facilitate expectoration in order to improve symptoms, prevent recurrent exacerbations and so enhance the quality of life [2]. In patients with stable COPD, the spirometric response to bronchodilators such as b 2 -agonists, anticholinergic drugs and methylxanthines is at best very modest. However, even in the absence of significant bronchodilation, an improvement in symptoms and exercise tolerance can be demonstrated [3].Salmeterol xinofoate, a long-acting b 2 -agonist, has been shown in single-dose studies to induce a spirometric improvement over a 12-h period in patients with COPD [4± 6]. In addition, three studies in patients with COPD over periods of 1±3 months have found that treatment with salmet...

show abstract

Section: Discussionmentioning

confidence: 85%

mentioning

confidence: 99%

Long-term treatment of chronic obstructive pulmonary disease with salmeterol and the additive effect of ipratropium

et al. 2000

View full text Add to dashboard Cite

show abstract

“…They are given on a regular basis in 'Moderate' to 'Very Severe' disease, (Stages II-IV) or on an as-needed basis at all stages of the disease in order to relieve breathlessness and improve exercise capacity. For regular treatment, long-acting bronchodilators are more effective [23,24] *** and more convenient than short-acting bronchodilators, although they are more expensive. …”

Section: Treatments Availablementioning

confidence: 99%

International Primary Care Respiratory Group (IPCRG) Guidelines: Management of Chronic Obstructive Pulmonary Disease (COPD)

Bellamy¹,

Bouchard

Henrichsen

et al. 2006

Primary Care Respiratory Journal

View full text Add to dashboard Cite

Summary COPD is a common and under-diagnosed disease which is increasing in prevalence worldwide. A more aggressive and optimistic approach must be adopted towards its management in primary care. This IPCRG Guideline on the management of COPD in primary care is fully consistent with GOLD guidelines. It highlights the goals of COPD treatment and the need for spirometric testing to make the diagnosis. It covers the classification of the disease according to disease severity, non-pharmacologic therapy including smoking cessation, avoidance of risk factors, patient education, pharmacologic therapy including the use of oxygen treatment, the management of exacerbations, the role of pulmonary rehabilitation, and the need for monitoring and ongoing care for COPD patients.

show abstract

“…The long-acting muscarinic receptor antagonist tiotropium has been shown significantly to improve lung function, dyspnoea, exercise tolerance, and health related quality of life in patients with COPD, relative to placebo [16][17][18]. The two currently available LABAs -salmeterol and formoterol -also show significant improvements in lung function, health status, and symptom reduction, compared with both placebo [19][20][21][22] and ipratropium [23,24].…”

Section: Treatment Options For Copdmentioning

confidence: 99%

Effective management of COPD in primary care — the role of long-acting beta agonist/inhaled corticosteroid combination therapy

Schayck

Reid

2006

Primary Care Respiratory Journal

View full text Add to dashboard Cite

Summary Chronic obstructive pulmonary disease (COPD) is the internationally preferred term for chronic, progressive lung disorders which are characterised by airflow limitation that is not fully reversible. The symptoms of COPD -including breathlessness, cough, excessive sputum production and reduced muscle tone and muscle wasting -reflect the complex pathophysiology of the disease. In order to address these symptoms, treatment regimens should take into account the multiple components that contribute to COPD. Clinical evidence has emerged indicating that, especially in patients with severe COPD, long-acting beta 2 -agonists (LABAs) and inhaled corticosteroids (ICS) result in improvements in symptoms, reduce the frequency and severity of exacerbations, and improve health-related quality of life. This review evaluates the clinical evidence for the potential of LABA/ICS treatment to address the symptoms of COPD and whether combination therapy of this nature adds significant benefit to patients.

show abstract

Efficacy of Salmeterol Xinafoate in the Treatment of COPD

Cited by 465 publications

References 22 publications

Long-term treatment of chronic obstructive pulmonary disease with salmeterol and the additive effect of ipratropium

Long-term treatment of chronic obstructive pulmonary disease with salmeterol and the additive effect of ipratropium

International Primary Care Respiratory Group (IPCRG) Guidelines: Management of Chronic Obstructive Pulmonary Disease (COPD)

Effective management of COPD in primary care — the role of long-acting beta agonist/inhaled corticosteroid combination therapy

Contact Info

Product

Resources

About