Comparison of the clinical effects of combined salmeterol/fluticasone delivered by dry powder or pressurized metered dose inhaler. (April 2016)

• Record Type: Journal Article
• Authors: Hojo, Masayuki; Shirai, Toshihiro; Hirashima, Junko; Iikura, Motoyasu; Sugiyama, Haruhito
• Is Part Of: Pulmonary pharmacology & therapeutics. Volume 37(2016:Apr.)
• Page Start: 43
• Page End: 48
• Publication Date: 2016-04
• Subjects: Bronchial asthma -- Salmeterol/fluticasone combination inhaler -- Dry powder inhaler -- Pressurized metered dose inhaler -- Forced oscillation technique; ACT asthma control test -- BUD/FM budenoside/formoterol -- DPI dry powder inhaler -- COPD chronic obstructive pulmonary disease -- FeNO fractional exhaled nitric oxide -- FEV forced expiratory volume -- FOT forced oscillation technique -- ICS inhaled corticosteroids -- LABA long-acting β2-agonist -- pMDI pressurized metered dose inhaler -- R5 (20) respiratory system resistance at 5 (20) Hz -- R5−R20 difference between R5 and R20 -- SFC salmeterol/fluticasone combination -- X5 reactance at 5 Hz; Respiratory organs -- Diseases -- Chemotherapy -- Periodicals; 615.7205
• DOI: 10.1016/j.pupt.2016.02.004
• Languages: English
• ISSNs: 1094-5539

Abstract

Abstract: The salmeterol/fluticasone combination (SFC) inhaler is currently the most widely used maintenance drug for asthmatics worldwide. Although the effectiveness of SFC as either a dry powder inhaler (DPI) or a pressurized metered dose inhaler (pMDI) is well documented, there is limited data comparing the clinical efficacies of the two devices. To address this issue, we carried out a randomized crossover trial in which asthmatic patients (n = 47; mean age, 62.5 ± 16.5 years old) received a 12-week treatment of SFC DPI (50/250 μg twice daily) or SFC pMDI (four puffs of 25/125 μg daily). After a 4-week washout period, patients received another crossover treatment for 12 weeks. Respiratory resistance and reactance were measured by forced oscillation technique (MostGraph-01), spirometry, fractional exhaled nitric oxide (FeNO), and an asthma control test (ACT) every 4 weeks. The mean forced expiratory volume1.0 at the baseline was 2.16 ± 0.86 (L). Respiratory system resistance at 5 Hz (R5), the difference between R5 and R at 20 Hz (R5 – R20), and FeNO improved in both treatment groups, while reactance at 5 Hz (X5) and ACT score improved only in the pMDI group. In patients >70 years old (n = 21), R5, R5 – R20, ΔX5, and FeNO improved only in the pMDI group. These results suggest that SFC by pMDI produces a stronger anti-inflammatory and bronchodilatory effect even in patients whose asthma is well controlled by SFC delivered by DPI.