Fluticasone propionate/salmeterol and exercise‐induced asthma in children with persistent asthma

Abstract

Chronic dosing with fluticasone propionate/salmeterol in a single device provides superior protection compared with an inhaled corticosteroid alone in protecting against exercise-induced asthma in children with persistent asthma.

Rethinking the prevalence of exercise-induced bronchoconstriction in patients with asthma

“…Despite literature suggesting high rates of EIB in patients with asthma 1,3,5,9 , rates of EIB found in this study and others 10–13 which enlisted rigorous EIB protocols in cohorts with symptoms of EIB, have found much lower rates. Potential reasons for the discrepancy between these results may be due to variable measures of EIB, variable thresholds for determining a positive test, and differences in populations tested.…”

“…In comparison to the historic literature which largely focuses on elite athletes and military conscripts 5 , the demographic included in our screened population was notably urban and typically overweight. Prior studies sampling the general asthma population also found lower prevalence of EIB (44 – 60% 10–13 ) than typically referenced, which may support demographics playing a role. In such populations, alternate diagnoses for exercise induced dyspnea, such as deconditioning or obesity, are more likely to play a role than those enrolling athletes.…”

Evaluation of Fluticasone Propionate and Fluticasone Propionate/Salmeterol Combination on Exercise in Pediatric and Adolescent Patients with Asthma

“…A statistical difference was not observed when the mean maximal percent falls between treatments were analyzed (p=0.158), unlike in the identically-designed replicate study reported by Pearlman and colleagues [9] (Fig. 3 ).…”

“…However, previous studies have shown LABA plus ICS to statistically significantly attenuate the fall in FEV 1 compared with ICS alone for patients with chronic asthma and in whom symptoms are triggered by exercise [8, 9, 13]. Unlike the current study, a replicate study confirmed a statistically significant improvement in EIB protection in children and adolescents using FSC compared with FP [9]. However, even in this study, questions were raised concerning adherence to study medications especially in the adolescent group which is known to be a high risk group for poor adherence.…”

“…The protocol and subject consent forms were approved by the respective Institutional Review Boards at all participating investigative sites and conducted in compliance with Good Clinical Practices. The study was identical to a duplicate study and detailed inclusion/exclusion criteria, methods and procedures, including exercise challenge and serial forced expiratory volume in once second (FEV 1 ), have been previously reported [9]. …”