Salmeterol versus slow-release theophylline combined with ketotifen in nocturnal asthma: a multicentre trial. French Multicentre Study Group

Abstract

We wished to assess the efficacy of inhaled salmeterol (SML; 50 micrograms b.i.d.) compared to a combination of slow-release theophylline and ketotifen p.o. (TK; T 300 mg+K 1 mg b.i.d.) for the treatment of nocturnal asthma. Ninety six patients with nocturnal asthma, (forced expiratory volume in one second (FEV1) 60-90% of predicted value, reversibility > or = 15%, at least two nocturnal awakenings per week) were eligible for a multicentre, double-blind, double-dummy cross-over study (14-day run-in, two successive 28-day treatment periods). Efficacy was assessed as success/failure, success being defined as the complete disappearance of nocturnal symptoms/awakening during the last week of each treatment period. There was a statistically significant difference between SML and TK for this criterion: 46% and 39% success with SML during periods I (first 28-day period) and II (following the cross-over), compared to only 15% and 26% with TK, respectively (p < 0.01). SML was also significantly better for the other criteria (lung function, rescue salbutamol intake during day and night). Side-effects were five times less frequent in SML-treated patients (p < 0.004). Efficacy and tolerance of SML were obviously far better than those of TK in patients with nocturnal asthma.

Role of Chronotherapy in Disease Control and Prevention

“…Similar to theophylline, little to no information is available on how to evaluate or include a long-acting 2-agonist oral instruction to an inhaled corticosteroid using chronotherapeutic approaches. Salmeterol and formoterol, two longacting 2-agonists for the treatment of these medications have less side effects than long-acting oral medications (Muir et al, 1992;Rabe et al, 1993), for nocturnal asthma (D'Alonzo et al, 1990, Fitzpatrick et al, 1990. In patients with persistent asthma, salmeterol improves daytime cognitive function and sleep quality (Fitzpatrick et al, 1990, Muir et al, 1992.…”

“…Salmeterol and formoterol, two longacting 2-agonists for the treatment of these medications have less side effects than long-acting oral medications (Muir et al, 1992;Rabe et al, 1993), for nocturnal asthma (D'Alonzo et al, 1990, Fitzpatrick et al, 1990. In patients with persistent asthma, salmeterol improves daytime cognitive function and sleep quality (Fitzpatrick et al, 1990, Muir et al, 1992. Glycine 16 polymorphism (Szefler et al, 1991), which is connected to the downregulation of 2 receptors that takes place throughout the night in nocturnal asthma (Selby et al, 1997), must be taken into consideration in any advancements in 2-agonist therapy.…”

“…List of diseases: GI Diseases and GI carcinogenesis are circadian based therapeutic interventions which includes pharmacotherapy, chronotherapy. Melatonin in GI diseases (Muir et al, 1992). There is a link between shift work, which is practised by an estimated 16% of the population, and a number of illnesses, including those that influence metabolic functioning.…”