Chronic obstructive pulmonary disea...

Chronic obstructive pulmonary disease (COPD) which is characterized by way of airflow limitation that is not to the full reversible, affects a significant portion of Americans and is the fourth leading cause of death in the United States. now passing treatment guidelines recommend bronchodilators as first-line therapy. Depending upon the disease severity, inhaled corticosteroids may be added. Multiple studies examining the use of inhaled corticosteroids in patients with COPD have shown that corticosteroids have a positive impact forward short- and long-term clinical issues In addition, one study rest that inhaled corticosteroids reduced COPD-related morbidity and mortality in somewhat old patients. Inhaled salmeterol has prov effective in improving lung function, symptoms, and quality of life in patients with COPD Hanania and associates evaluated the efficacy and safety of a combination of fluticasone propionate and salmeterol in patients with COPD

The randomized, double-blind, placebo-controlled, parallel-group, multicenter trial listed patients who had a diagnosis of COPD as defined by dint of the American Thoracic Society and who met spirometry parameters. After a two-week run-in, patients were randomized to receive 250 mcg of fluticasone, 50 mcg of salmeterol, a combination of the couple agents, or placebo delivered twice daily from one side a single device for 24 weeks. Treatment efficacy was assessed on measuring forced expiratory volume in common second (FE[V.sub.1]) before and couple hours after medication use. Other measures assessed included morning peak expiratory result (PEF), dyspnea symptoms, supplemental albuterol use, health status, symptoms of chronic bronchitis, and exacerbation of symptoms. Safety was evaluated at recording adverse events, electrocardiogram readings, vital signs, clinical laboratory proofs oropharyngeal examinations and, in one centers, results of a cosyntropin-stimulation test

Compared with placebo or salmeterol alone, the combination of fluticasone and salmeterol significantly increased pre-dose FE[Vsub1] The combination treatment also significantly improved the two-hour post-dose FE[Vsub1] compared with placebo and fluticasone alone. Lung function as measured according to morning PEF improved with the fluticasone/salmeterol combination. Compared with placebo, the combination significantly improved dyspnea, quality of life, and symptoms of bronchitis. Adverse results were similar between the four treatment clumps except for oral candidiasis, which was higher in the combination and fluticasone-only groups

The authors judge that a combination of fluticasone and salmeterol twice daily substantially improves lung function in patients with COPD compared with either medication alone throughout a 24-week period. They note that the combination therapy does not increase adverse affairs compared with use of individual agents.

Hanania NA, et al. The efficacy and safety of fluticasone propionate (250 [micro]g)/salmeterol (50 [micro]g) combined in the Diskus inhaler for the treatment of COPD Chest September 2003;124:834-43

COPYRIGHT 2004 American Academy of Family Physicians

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