Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 1999 Mar;54(3):207-12.
doi: 10.1136/thx.54.3.207.

Addition of salmeterol versus doubling the dose of fluticasone propionate in patients with mild to moderate asthma

J A van Noord  1 , A J Schreurs, S J Mol, P G Mulder
Affiliations
Clinical Trial

Addition of salmeterol versus doubling the dose of fluticasone propionate in patients with mild to moderate asthma

J A van Noord et al. Thorax. 1999 Mar.

Abstract

Background: The objective of this multicentre, randomised, double blind, parallel group study was to compare the efficacy and safety of the addition of salmeterol with that of doubling the dose of fluticasone propionate in asthmatic patients not controlled by a low or intermediate dose of inhaled corticosteroids.

Methods: After a four week run in period of treatment with fluticasone propionate (100 micrograms twice daily if pre-trial dose was 400-600 micrograms inhaled corticosteroids or 250 micrograms twice daily if pre-trial dose was 800-1200 micrograms inhaled corticosteroids), 274 patients were randomised to treatment for 12 weeks with either salmeterol 50 micrograms twice daily plus the run in dose of fluticasone propionate or twice the run in dose of fluticasone propionate (200 or 500 micrograms twice daily). Outcome measures were daily records of peak expiratory flow (PEF), symptom scores, and clinic lung function.

Results: The improvements in both the morning and evening PEF were better in the salmeterol than in the fluticasone propionate group, the mean increase in morning PEF being 19 l/min higher (95% CI 11.0 to 26.1) and in evening PEF being 16 l/min (95% CI 18.4 to 24.0) higher in the salmeterol group. The increase in forced expiratory volume in one second (FEV1) was 0.09 1 greater in the salmeterol group than in the fluticasone propionate group after four weeks of treatment (95% CI 0.01 to 0.18), but not after 12 weeks. Both regimens showed an increase in symptom free days and a reduction in the need for rescue salbutamol both during the day and the night, but these improvements were greater in the salmeterol group. There were no significant differences between the groups in adverse effects or in the number of rescue course of oral corticosteroids.

Conclusions: In this group of patients still symptomatic despite 100 or 250 micrograms fluticasone propionate twice daily, the addition of salmetterol caused a greater improvement in lung function and symptom control than doubling the dose of fluticasone propionate.

PubMed Disclaimer

References

    1. Am Rev Respir Dis. 1990 Sep;142(3):571-5 - PubMed
    1. N Engl J Med. 1997 Nov 13;337(20):1405-11 - PubMed
    1. Lancet. 1990 Dec 8;336(8728):1391-6 - PubMed
    1. N Engl J Med. 1991 Aug 8;325(6):388-92 - PubMed
    1. Am Rev Respir Dis. 1992 Sep;146(3):547-54 - PubMed

Publication types

MeSH terms