Fluticasone propionate, salmeterol xinafoate, and their combination in the treatment of nocturnal asthma

Autor: Gerard H. Koëter, Rob R. Douma, Dirkje S. Postma, E. J. M. Weersink
Přispěvatelé: Other departments, Groningen Research Institute for Asthma and COPD (GRIAC)
Rok vydání: 1997
Předmět:
Male
Budesonide
SYMPTOMS
AIRWAY INFLAMMATION
Administration
Topical
Anti-Inflammatory Agents
Critical Care and Intensive Care Medicine
RESPONSIVENESS
Bronchoconstrictor Agents
DOUBLE-BLIND
HISTAMINE
Bronchodilator
Medicine
Anti-Asthmatic Agents
Salmeterol Xinafoate
Methacholine Chloride
Fluticasone
Adrenergic beta-Agonists
respiratory system
ADENOSINE
Circadian Rhythm
CONTROLLED TRIAL
Bronchial hyperresponsiveness
Drug Therapy
Combination
Female
Salmeterol
Bronchial Hyperreactivity
medicine.drug
Adult
Pulmonary and Respiratory Medicine
medicine.medical_specialty
medicine.drug_class
INHALED SALMETEROL
Bronchial Provocation Tests
Fluticasone propionate
Double-Blind Method
BUDESONIDE
Internal medicine
Administration
Inhalation
Humans
Albuterol
Glucocorticoids
Asthma
business.industry
INDUCED BRONCHOCONSTRICTION
medicine.disease
Adenosine Monophosphate
Androstadienes
Endocrinology
Methacholine
business
Zdroj: American journal of respiratory and critical care medicine, 155(4), 1241-1246. American Thoracic Society
American Journal of Respiratory and Critical Care Medicine, 155(4), 1241-1246. AMER THORACIC SOC
ISSN: 1535-4970
1073-449X
DOI: 10.1164/ajrccm.155.4.9105061
Popis: Inhaled corticosteroids have been shown to effectively reduce large circadian fluctuations in peak expiratory flow (PEF). Salmeterol xinafoate (SLM), a new long-acting beta(2)-agonist being used in the treatment of nocturnal airway obstruction, has proved to be very effective in this respect as well. However, it is yet unknown whether using SLM alone or in combination with fluticasone propionate (FP) constitutes the best treatment. We studied, in a randomized, double-blind, parallel manner, 46 asthmatics with increased circadian variation in PEF (greater than or equal to 15%) for 6 wk to compare FP 250 mu g, SLM 50 mu g, and a combination of them, all given twice a day. These three treatment protocols were equally effective in improving the generally used clinical outcome parameters, i.e., the circadian variation in PEF and FEV(1) and bronchial hyperresponsiveness (BHR) to methacholine (MCh) during the day and at night. FEV(1) increased more at 4:00 A.M. than at 4:00 P.M. (FEV(1) at both time points > 90% predicted). BHR to MCh improved with at least 1.5 doubling concentrations, thereby reducing the significant nocturnal decline in the SLM and FP group, but not in combination. The improvement in BHR to adenosine 5'monophosphate was greater (p = 0.05) when FP was combined with SLM but not when FP or SLM were used alone. Our data support the clinical view that FP, with its anti-inflammatory capacity, has greater beneficial effects as monotherapy than does SLM. However, this was detectable only by using the ''indirect'' stimulus adenosine 5'monophosphate, which is more specific in assessing changes in different components of airway wall inflammation than is MCh.
Databáze: OpenAIRE
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