Salmeterol/fluticasone combination in the treatment of COPD |
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Authors: | K F Chung |
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Institution: | National Heart and Lung Institute, Imperial College and Royal Brompton Hospital, London, UK |
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Abstract: | Clinical trials of a combination therapy of an inhaled corticosteroid, fluticasone propionate (FP), with a long-acting β2-agonist, salmeterol (Sal), have demonstrated a greater improvement in lung function and in quality of life measures after the combination compared with either component of alone. In a subanalysis of the data of the TRISTAN study, Sal/FP reduced exacerbation rates in COPD patients with a baseline FEV1<50% of predicted. A combination therapy of budesonide and formoterol improved quality of life and FEV1, and reduced exacerbations better than either component alone. In studies of FP or of Sal/FP in COPD, there was a reduction in all-cause mortality by 25% relative to placebo. Sal/FP has anti-inflammatory effects in COPD airways. FP inhibits markers of systemic inflammation, and it is not known whether Sal/FP has an advantage over FP alone. While long-acting β2-agonists such as Sal can be recommended for treatment of moderate COPD, addition of inhaled steroid therapy such as FP should be considered in more severe disease. |
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Keywords: | fluticasone salmeterol COPD |
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