Fluticasone propionate and salmeterol administered via Diskus compared with salmeterol or fluticasone propionate alone in patients suboptimally controlled with short-acting β2-agonists

Murray, John; Rosenthal, Richard R.; Somerville, Laura L.; Blake, Kathryn; House, Karen; Baitinger, Leslie; VanderMeer, Anna; Dorinsky, Paul

doi:10.1016/s1081-1206(10)61394-4

Cited by 35 publications

(19 citation statements)

References 18 publications

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“…Since the publication of these systematic reviews, further RCTs have been published comparing LABA/ICS to a similar ICS dose in steroid-naive subjects and a similar maintenance ICS dose. [23][24][25][26][27][28] The results of these RCTs support the results of the systematic reviews included in this analysis.…”

Section: Discussionsupporting

confidence: 79%

See 1 more Smart Citation

Differential effects of maintenance long-acting β-agonist and inhaled corticosteroid on asthma control and asthma exacerbations

Gibson

Powell

Ducharme

2007

Journal of Allergy and Clinical Immunology

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Section: Discussionsupporting

confidence: 79%

“…requiring OCS compared with a similar ICS dose(Table II,Fig 4). Treatment of 18 people with LABA/ICS combination therapy prevented 1 person from experiencing a severe exacerbation compared with a similar ICS dose alone (NNT [95% CI] 5 18[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32];…”

mentioning

confidence: 99%

Differential effects of maintenance long-acting β-agonist and inhaled corticosteroid on asthma control and asthma exacerbations

Gibson

Powell

Ducharme

2007

Journal of Allergy and Clinical Immunology

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“…In contrast with our results and those of the OPTIMA group A, two studies conducted for 12 weeks in steroid-naive (for at least 1 month) asthmatic patients have shown less exacerbation, higher FEV 1 improvement and in one of them better symptom control for patients treated with a combination of LABA and ICS compared to ICS alone [13, 14]. However, the ICS fluticasone daily dosages, respectively, 100 and 200 µg/day, were obviously too low for patients with notable obstruction as stated by mean baseline FEV 1 of 65–67% of predicted [2].…”

Section: Discussioncontrasting

confidence: 99%

Asthma Control following Initial Inhaled Corticosteroid Monotherapy in Mild to Moderate Asthma: A 4- to 8-Week Observational Study

Giraud¹,

Rogeaux²,

Dusser

2006

Respiration

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Background: There is an increasing trend for the use of combination therapy of inhaled corticosteroids (ICS) and long-acting β₂-agonists as initial treatment for asthma. Objective: To assess the efficacy of initial monotherapy with ICS for achieving asthma control in steroid-naive mild to moderate asthmatics. Method: During an observational survey, steroid-naive patients received ICS in a dosage of 400–2,000 µg/day. After 4–8 weeks’ treatment, achievement of asthma control, defined according to the Global Initiative for Asthma (GINA) guidelines, was assessed and the Asthma Control Questionnaire (ACQ) was completed. Results: Among 537 selected patients, 21 were excluded because of severe asthma and 96 because of inadequate ICS daily dosage. Four hundred and twenty patients were analyzed, 396 (94%) of whom completed the survey. Mean ICS dosage, in equivalent beclomethasone, was 479 ± 62 µg/day for mild asthma (group A) and 1,115 ± 306 µg/day for moderate asthma (group B). Asthma control was achieved for 71 and 65% of the patients, mean ACQ score improved from 1.1 ± 0.6 to 0.5 ± 0.5 (p < 0.001) and from 2.0 ± 0.8 to 0.8 ± 0.7 (p < 0,001), and FEV₁ (% predicted) improved from 93 ± 9 to 96 ± 13 (p < 0.05) and from 85 ± 15 to 91 ± 15 (p < 0.001) for groups A and B, respectively. Conclusion: Asthma control can be achieved by ICS monotherapy for two thirds of steroid-naive patients with mild to moderate asthma. For these patients, we suggest that ICS alone could be started as initial therapy and that additional therapy should be considered after 4–8 weeks for patients who do not achieve control.

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“…Patients randomized to SFC (50 g/100 g bd) or FP (100 g bd) for 24 wk Significantly greater increase in % of symptom-free days and nights for SFC than FP (adjusted treatment difference: 15.3%, P ϭ 0.008) Significantly greater improvement in lung function for SFC than FP (P Յ 0.011) Significantly greater increase in % of days and nights without salbutamol use for SFC than FP (P Ͻ 0.05) Combination treatment with SFC improved morning PEF rate (P ϭ 0.0011) and evening PEF rate (P ϭ 0.011) significantly more than FP alone Murray et al 37 Uncontrolled asthma (using as-needed short-acting ␤2 agonists alone or symptomatic) (n ϭ 267)…”

Section: Fp Plus Salmeterol: the Benefits Of Adding Salmeterol Rathermentioning

confidence: 96%

“…7 Studies have demonstrated that greater asthma control can be achieved with SFC rather than FP alone as initial controller therapy (Table 2). [35][36][37] Barnes et al conducted a post hoc integrated analysis of 4 randomized, double-blind parallel-group studies that included patients who had received initial controller therapy with SFC (50 g/100 g bd) or FP (100 g bd). 36 Patients with asthma that was poorly controlled at baseline (exhibiting 2 or more of the following: moderate-to-severe airflow limitation, daily symptoms, daily use of rescue medication) were significantly more likely to achieve well controlled asthma with SFC than with FP alone.…”

Section: Ics Plus Laba As First-line Therapy To Treat Uncontrolled Asmentioning

confidence: 99%

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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Fluticasone propionate and salmeterol administered via Diskus compared with salmeterol or fluticasone propionate alone in patients suboptimally controlled with short-acting β2-agonists

Cited by 35 publications

References 18 publications

Differential effects of maintenance long-acting β-agonist and inhaled corticosteroid on asthma control and asthma exacerbations

Differential effects of maintenance long-acting β-agonist and inhaled corticosteroid on asthma control and asthma exacerbations

Asthma Control following Initial Inhaled Corticosteroid Monotherapy in Mild to Moderate Asthma: A 4- to 8-Week Observational Study

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

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