The effect of inhaled salmeterol, alone and in combination with fluticasone propionate, on management of COPD patients.
BACKGROUND
Airway inflammation is a known pathological feature of chronic obstructive pulmonary disease (COPD). We examined the effect of inhaled salmeterol, alone and in combination with fluticasone propionate, on the management of patients with COPD.


METHODS
Forty male COPD patients were randomly divided into two groups; group 1 (n=20) were treated with long-acting ß2-agonist, and group 2 (n=20) with long-acting ß2-agonist and inhaled glucocoticoid each day for 3 months. Pulmonary function tests (PFTs), including forced vital capacity (FVC), forced expiratory volume in 1s (FEV1) and peak expiratory flow (PEF), were measured at the beginning, 1 and 2 months after treatment and at the end of the study. The frequency of using inhaled salbutamol/day and the 6-min walk distance were also measured at four different visits. The frequency of exacerbation was also recorded during the 90-day treatment period in the two groups.


RESULTS
FEV(1) , FVC and PEF were significantly higher after 30 days of treatment with fluticasone propionate (mean change from baseline in group 2: 155mL, 200mL and 70L/s, respectively; P<0.001). Six-minute walk distance also increased significantly (mean change from baseline: 160 m; P < 0.001), and there was a 70%-80% reduction in the use of inhaled salbutamol (P<0.001). All improvements were maintained over the remainder of the study period. Exacerbations over the 90-day treatment period were significantly fewer than in the same 90-day period in the previous year (2.8±0.7 vs 0.8±0.9; P<0.001). In contrast, only PEF increased significantly with treatment in group 1 (salmeterol treatment alone).


CONCLUSIONS
These results indicated that inhaled corticosteroids may be beneficial in some patients with COPD.
Mansori
Fariba
F
Department of Medicine, Medical School, Kermanshah University of Medical Sciences, Mashhad, Iran.
Nemat Khorasani
Anaiatolah
A
Boskabady
Mohammad Hossein
MH
Boskabady
Morteza
M
D000280:Administration, Inhalation; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage*; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000730:Androstadienes / Q000008:administration & dosage*; D004338:Drug Combinations; D000068297:Fluticasone-Salmeterol Drug Combination; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy*; D012129:Respiratory Function Tests; D000068299:Salmeterol Xinafoate; D016896:Treatment Outcome
D058666:Adrenergic beta-2 Receptor Agonists; D000730:Androstadienes; D004338:Drug Combinations; D000068297:Fluticasone-Salmeterol Drug Combination; D005938:Glucocorticoids; D000068299:Salmeterol Xinafoate; D000420:Albuterol