Does salmeterol facilitate 'step-down' therapy in patients with asthma receiving moderate to high doses of inhaled corticosteroids?

Timothy Self, Mark J. Rumbak, Tiffany Kelso, Louis Eberle, Nabil Abou-Shala, Cheryl C. Learned, Nicole Beiers, Elizabeth Tolley

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The purpose of this study was to determine if salmeterol facilitates 'step-down' therapy in patients with asthma receiving moderate to high doses of inhaled corticosteroids (ICS). The double-masked, placebo-controlled, 12- month trial comprised 24 adult patients with moderate-to-severe persistent asthma who required an ICS dosage of at least 1000 μg/d. Patients were randomized to receive either salmeterol 50 μg (2 puffs every 12 hours) or matching placebo (2 puffs every 12 hours) while adhering to their previous maintenance regimen. After 2 weeks of salmeterol therapy or placebo, the ICS dosage was reduced at least 10% every 4 weeks as long as peak expiratory flow (PEF), forced expiratory volume in the first second (FEV1), and the requirement of 'as-needed' albuterol were constant. Between-group differences were assessed by the percent reduction in ICS dose, PEF, FEV1, need for 'rescue' albuterol or bursts of prednisone, and an asthma quality-of-life measure. Although the mean percent reduction in ICS dose was not significantly different between groups, patients in the salmeterol group (n = 12) were 2.3 times as likely to have some ICS dosage reduction as those in the placebo group (95% confidence interval, 0.8 to 6.9). At the end of 12 months, FEV1 was significantly higher in the salmeterol group (81.5% of predicted) versus placebo group (66.4% of predicted). Other secondary measures, including clinic measurement of PEF, albuterol use, and acute exacerbations, were similar between groups. Overall asthma quality of life improved in the salmeterol group versus the placebo group. Although salmeterol did not affect the percent reduction in ICS dose, more patients had some ICS dosage reduction with salmeterol, and FEV1 was greater at the end of 12 months and quality of life was improved.

Original languageEnglish (US)
Pages (from-to)803-811
Number of pages9
JournalCurrent Therapeutic Research - Clinical and Experimental
Volume59
Issue number11
DOIs
StatePublished - Jan 1 1998

Fingerprint

Adrenal Cortex Hormones
Asthma
Placebos
Albuterol
Quality of Life
Therapeutics
Salmeterol Xinafoate
Forced Expiratory Volume
Prednisone
Maintenance
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)

Cite this

Does salmeterol facilitate 'step-down' therapy in patients with asthma receiving moderate to high doses of inhaled corticosteroids? / Self, Timothy; Rumbak, Mark J.; Kelso, Tiffany; Eberle, Louis; Abou-Shala, Nabil; Learned, Cheryl C.; Beiers, Nicole; Tolley, Elizabeth.

In: Current Therapeutic Research - Clinical and Experimental, Vol. 59, No. 11, 01.01.1998, p. 803-811.

Research output: Contribution to journalArticle

Self, Timothy ; Rumbak, Mark J. ; Kelso, Tiffany ; Eberle, Louis ; Abou-Shala, Nabil ; Learned, Cheryl C. ; Beiers, Nicole ; Tolley, Elizabeth. / Does salmeterol facilitate 'step-down' therapy in patients with asthma receiving moderate to high doses of inhaled corticosteroids?. In: Current Therapeutic Research - Clinical and Experimental. 1998 ; Vol. 59, No. 11. pp. 803-811.
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