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American Journal of Respiratory and Critical Care Medicine Vol 166. pp. 1084-1091, (2002)
© 2002 American Thoracic Society

Articles

Effectiveness of Fluticasone Propionate and Salmeterol Combination Delivered via the Diskus Device in the Treatment of Chronic Obstructive Pulmonary Disease

Donald A. Mahler, Patrick Wire, Donald Horstman, Chai-Ni Chang, Julie Yates, Tracy Fischer and Tushar Shah

Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire; and GlaxoSmithKline, Research Triangle Park, North Carolina

Correspondence and requests for reprints should be addressed to to Donald A. Mahler, M.D., Dartmouth Hitchcock Medical Center, Section of Pulmonary and Critical Care Medicine, 1 Medical Center Drive, Lebanon, NH 03756–0001. E-mail: donald.a.mahler{at}hitchcock.org

ABSTRACT

This randomized controlled trial examined the benefits of combining an inhaled corticosteroid, fluticasone propionate (F), with an inhaled long-acting ß2-agonist, salmeterol (S), to treat the inflammatory and bronchoconstrictive components of chronic obstructive pulmonary disease (COPD). A total of 691 patients with COPD received the combination of F and S (FSC), S (50 mcg), F (500 mcg), or placebo twice daily via the Diskus device for 24 weeks. A significantly greater increase in predose FEV1 at the endpoint was observed after FSC (156 ml) compared with S (107 ml, p = 0.012) and placebo (-4 ml, p < 0.0001). A significantly greater increase in 2-hour postdose FEV1 at the endpoint was observed after treatment with FSC (261 ml) compared with F (138 ml, p < 0.001) and placebo (28 ml, p < 0.001). There were greater improvements in the Transition Dyspnea Index with FSC (2.1) compared with F (1.3, p = 0.033), S (0.9, p < 0.001), and placebo (0.4, p < 0.0001). The incidence of adverse effects (except for an increase in oral candidiasis with FSC and F) was similar among the treatment groups. We conclude that FSC improved lung function and reduced the severity of dyspnea compared with individual components and placebo.

Key Words: chronic obstructive pulmonary disease • ß2-agonist • inhaled corticosteroid • Transition Dyspnea Index




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