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International Journal of Chronic Obstructive Pulmonary Disease
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Salmeterol/fluticasone combination in the treatment of COPD
(2381) Views (534) Full article downloads
Authors: K F Chung
Published Date May 2006
Volume 2006:1(3) Pages 235 - 242
DOI: http://dx.doi.org/10.2147/COPD.S
K F Chung
National Heart and Lung Institute, Imperial College and Royal Brompton Hospital, London, UK
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.
Keywords: fluticasone, salmeterol, COPD
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