title: Efficacy of salmeterol xinafoate in the treatment of COPD.
abstract: OBJECTIVE
  To examine and compare the efficacy and safety of salmeterol xinafoate, a long-acting inhaled beta2-adrenergic agonist, with inhaled ipratropium bromide and inhaled placebo in patients with COPD.
  
  
  METHODS
  A stratified, randomized, double-blind, double-dummy, placebo-controlled, parallel group clinical trial.
  
  
  METHODS
  Multiple sites at clinics and university medical centers throughout the United States.
  
  
  METHODS
  Four hundred eleven symptomatic patients with COPD with FEV1 < or = 65% predicted and no clinically significant concurrent disease.
  
  
  METHODS
  Comparison of inhaled salmeterol (42 microg twice daily), inhaled ipratropium bromide (36 microg four times a day), and inhaled placebo (2 puffs four times a day) over 12 weeks.
  
  
  RESULTS
  Salmeterol xinafoate was significantly (p < 0.0001) better than placebo and ipratropium in improving lung function at the recommended doses over the 12-week trial. Both salmeterol and ipratropium reduced dyspnea related to activities of daily living compared with placebo; this improvement was associated with reduced use of supplemental albuterol. Analyses of time to first COPD exacerbation revealed salmeterol to be superior to placebo and ipratropium (p < 0.05). Adverse effects were similar among the three treatments.
  
  
  CONCLUSIONS
  These collective data support the use of salmeterol as first-line bronchodilator therapy for the long-term treatment of airflow obstruction in patients with COPD.
authors: Dartmouth Medical School, Lebanon, NH, USA. Donald.a.mahler@hitchcock.org
authors: D A
authors: DA
authors: Mahler
authors: J F
authors: JF
authors: Donohue
authors: R A
authors: RA
authors: Barbee
authors: M D
authors: MD
authors: Goldman
authors: N J
authors: NJ
authors: Gross
authors: M E
authors: ME
authors: Wisniewski
authors: S W
authors: SW
authors: Yancey
authors: B A
authors: BA
authors: Zakes
authors: K A
authors: KA
authors: Rickard
authors: W H
authors: WH
authors: Anderson
mesh_terms: D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage* / Q000009:adverse effects; D000420:Albuterol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D009241:Ipratropium / Q000008:administration & dosage; D008173:Lung Diseases, Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D000068299:Salmeterol Xinafoate; D014797:Vital Capacity
chemical_list: D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D000068299:Salmeterol Xinafoate; D009241:Ipratropium; D000420:Albuterol