The Journal of Allergy and Clinical Immunology
Volume 111, Issue 1 , Pages 57-65 , January 2003

Steroid-sparing effects of fluticasone propionate 100 μg and salmeterol 50 μg administered twice daily in a single product in patients previously controlled with fluticasone propionate 250 μg administered twice daily

Presented in part at the American College of Chest Physicians Conference, San Diego, Calif, November 2-7, 2002.

Received 7 August 2002 ,Revised 13 September 2002 ,Accepted 9 October 2002.

References 

  1. National Institutes of Health . National Heart, Lung, and Blood Institute. Highlights of the expert panel report 2: guidelines for the diagnosis and management of asthma. NIH publication number 97-4051. Bethesda (MD): The Institutes; 1997;
  2. Donahue JG, Weiss ST, Livingston JM, Goetsch MA, Greineded DK, Platt R. Inhaled steroids and the risk of hospitalization for asthma. JAMA. 1997;277:887–891
  3. Adams RJ, Fuhlbrigge A, Finkelstein JA, Lozano P, Livingston JM, Weiss KB, et al.  Impact of inhaled anti-inflammatory therapy on hospitalization and emergency department visits for children with asthma. Pediatrics. 2001;107:706–711
  4. Suissa S, Ernst P, Benayoun S, Baltzan M, Cai B. Low-dose inhaled corticosteroids and the prevention of death from asthma. N Engl J Med. 2000;342:332–336
  5. Haahtela T, Jarvinen M, Kava T, Kiviranta K, Koskinen S, Lehtonen K, et al.  Effects of reducing or discontinuing inhaled budesonide in patients with mild asthma. New Engl J Med. 1994;33:700–705
  6. Selroos O, Pietinalho A, Lofroos AB, Riska H. Effect of early vs late intervention with inhaled corticosteroids in asthma. Chest. 1995;108:1228–1234
  7. Barnes PJ, Pedersen S, Busse WW. Efficacy and safety of inhaled corticosteroids. Am J Respir Crit Care Med. 1998;157(3 Part 2):S1–S53
  8. Bousquet J, Jeffery PK, Busse WW, Johnson M, Vignola AM. Asthma: from bronchoconstriction to airways inflammation and remodeling. Am J Respir Crit Care Med. 2000;161:1720–1745
  9. Olivieri D, Chetta A, Del Donno M, Bertorelli G, Casalini A, Pesci A, et al.  Effect of short-term treatment with low-dose inhaled fluticasone propionate on airway inflammation and remodeling in mild asthma: a placebo-controlled study. Am J Respir Crit Care Med. 1997;155:1864–1871
  10. Mak JCW, Nishikawa M, Barnes PJ. Glucocorticoids increase β2-adrenergic receptor transcription in human lung. Am J Physiol. 1995;268(1 Part 1):L41–L46
  11. Pauwels RA, Lofdahl CG, Postma DS, Tattersfield AE, O'Byrne P, Barnes PJ, et al.  Effect of inhaled formoterol and budesonide on exacerbations of asthma. N Engl J Med. 1997;337:1405–1411
  12. Wilding P, Clark M, Thompson CJ, Lewis S, Rushton L, Bennett J, et al.  Effect of long-term treatment with salmeterol on asthma control: a double-blind, randomized crossover study. BMJ. 1997;314:1441–1446
  13. Shrewsbury S, Pyke S, Britton M. Meta-analysis of increased dose of inhaled steroid or addition of salmeterol in symptomatic asthma (MIASMA). BMJ. 2000;320:1368–1373
  14. Kips JC, O'Connor BJ, Inman MD, Svensson K, Pauwels RA, O'Byrne PM. A long-term study of the anti-inflammatory effect of low-dose budesonide plus formoterol versus high-dose budesonide in asthma. Am J Respir Crit Care Med. 2000;161(3 Part 1):996–1001
  15. Sue-Chu M, Wallin A, Wilson S, Ward J, Sandstrom T, Djukanovic R, et al.  Bronchial biopsy study in asthmatics treated with low- and high-dose fluticasone propionate (FP) compared to low-dose FP combined with salmeterol [abstract]. Eur Respir J. 1999;14:124s
  16. Crapo RO. Reference values for lung function tests. Respiratory Care. 1989;34:626–637
  17. Polgar G, Promadhat V. Pulmonary function testing in children: techniques and standards. In: Philadelphia: WB Saunders; 1971;p. 1–269
  18. Blais L, Suissa S, Boivin JF, Ernst P. First treatment with inhaled corticosteroids and the prevention of admissions to hospital for asthma. Thorax. 1998;53:1025–1029
  19. Sin DD, Tu JV. Inhaled corticosteroid therapy reduces the risk of rehospitalization and all-cause mortality in elderly asthmatics. Eur Respir J. 2001;17:380–385
  20. Lemanske RF, Sorkness CA, Mauger EA, Lazarus SC, Boushey HA, Fahy JV, et al.  Inhaled corticosteroid reduction and elimination in patients with persistent asthma receiving salmeterol: a randomized controlled trial. JAMA. 2001;285:2594–2603
  21. Nielsen LP, Pedersen B, Faurschou P, Madsen F, Wilcke JT, Dahl R. salmeterol reduces the need for inhaled corticosteroid in steroid-dependent asthmatics. Respir Med. 1999;93:863–868
  22. Shapiro G, Lumry W, Wolfe J, Given J, White MV, Woodring A, et al.  Combined salmeterol 50μg and fluticasone propionate 250μg in the Diskus device for the treatment of asthma. Am J Respir Crit Care Med. 2000;161:527–534
  23. Lofdahl CG, Reiss TF, Leff JA, Israel E, Noonan MJ, Finn AF, et al.  Randomised, placebo controlled trial of effect of a leukotriene receptor antagonist, montelukast, on tapering inhaled corticosteroids in asthmatic patients. BMJ. 1999;319:87–90
  24. Chung KF. The complementary role of glucocorticoids and long-acting β-adrenergic agonists. Allergy. 1998;53:7–13
  25. Oddera S, Silvestri M, Testi R, Rossi GA. Salmeterol enhances the inhibitory activity of dexamethasone on allergen-induced blood mononuclear cell activation. Respiration. 1998;65:199–204
  26. Eikelberg O, Roth L, Rainer L, Bruce V, Rudiger J, Johnson M, et al.  Ligan-independent activation of the glucocorticoid receptor by β2-adrenergic receptor agonists in primary human lung fibroblasts and vascular smooth muscle cells. J Biol Chem. 1999;274:1005–1010
  27. Kavuru M, Melamed J, Gross G, LaForce C, House K, Prillaman B, et al.  Salmeterol and fluticasone propionate combined in a new powder inhalation device for the treatment of asthma: a randomized, double-blind, placebo-controlled trial. J Allergy Clin Immunol. 2000;105:1108–1116
  28. Tattersfield AE, Postma DS, Barnes PJ, Svensson K, Bauer CA, O'Byrne PM, et al.  Exacerbations of asthma: a descriptive study of 425 severe exacerbations. Am J Respir Crit Care Med. 1999;160:594–599
  29. Li X, Ward C, Thien F, Bish R, Bamford T, Bao X, et al.  An anti-inflammatory effect of salmeterol, a long-acting beta2 agonist, assessed in airway biopsies and bronchalveolar lavage in asthma. Am J Respir Crit Care Med. 1999;160:1493–1499
  30. Szefler SJ, Martin RJ, King TS, Boushey HA, Cherniack RM, Chinchilli VM, et al.  Significant variability in response to inhaled corticosteroids for persistent asthma. J Allergy Clin Immunol. 2002;109:410–418

☆ Reprint requests: William Busse, MD, University of Wisconsin, Medical School, K4/912-9988 Clinical Research Unit, 600 Highland Avenue, Madison, WI 53792.

PII: S0091-6749(02)91300-X

doi: 10.1067/mai.2003.38

The Journal of Allergy and Clinical Immunology
Volume 111, Issue 1 , Pages 57-65 , January 2003

Article Tools

* Image Usage & Resolution