Deterioration in Asthma Control When Subjects Receiving Fluticasone Propionate/Salmeterol 100/50 mcg Diskus are “Stepped-Down”

In this study, 647 subjects stable on fluticasone propionate/salmeterol Diskus 100/50 mcg BID (FSC) were randomized to continue FSC 100/50 mcg BID or “step down” to either fluticasone propionate (FP) 100mcg BID, salmeterol (SAL) 50 mcg BID, or montelukast (MON) 10 mg once daily for 16 weeks. Overall asthma control significantly improved in the FSC group; whereas, “stepping down” to FP, SAL, or MON resulted in deterioration in asthma control, as determined by decreased measures of lung function and clinical features. This study provides support that treatment of both inflammation and smooth muscle dysfunction may be necessary to achieve and maintain asthma control in patients uncontrolled on ICS.

[1]  P. Dorinsky,et al.  The Salmeterol Multicenter Asthma Research Trial: a comparison of usual pharmacotherapy for asthma or usual pharmacotherapy plus salmeterol. , 2006, Chest.

[2]  J. C. Carranza Rosenzweig,et al.  Improved refill persistence with fluticasone propionate and salmeterol in a single inhaler compared with other controller therapies. , 2004, The Journal of allergy and clinical immunology.

[3]  L. Edwards,et al.  Steroid-sparing effects of fluticasone propionate 100 μg and salmeterol 50 μg administered twice daily in a single product in patients previously controlled with fluticasone propionate 250 μg administered twice daily , 2003 .

[4]  Vernon M. Chinchilli,et al.  Long-Acting β2-Agonist Monotherapy vs Continued Therapy With Inhaled Corticosteroids in Patients With Persistent Asthma: A Randomized Controlled Trial , 2001 .

[5]  J. Matz,et al.  Addition of salmeterol to low-dose fluticasone versus higher-dose fluticasone: an analysis of asthma exacerbations. , 2001, The Journal of allergy and clinical immunology.

[6]  M. Kavuru,et al.  Salmeterol and fluticasone propionate combined in a new powder inhalation device for the treatment of asthma: a randomized, double-blind, placebo-controlled trial. , 2000, The Journal of allergy and clinical immunology.

[7]  W. Lumry,et al.  Combined Salmeterol 50 μ g and Fluticasone Propionate 250 μ g in the Diskus Device for the Treatment of Asthma , 2000 .

[8]  D. Postma,et al.  Exacerbations of asthma: a descriptive study of 425 severe exacerbations. The FACET International Study Group. , 1999, American journal of respiratory and critical care medicine.

[9]  Lynn Wei,et al.  Oral Montelukast, Inhaled Beclomethasone, and Placebo for Chronic Asthma , 1999, Annals of Internal Medicine.

[10]  M. Sears,et al.  Potential masking effects of salmeterol on airway inflammation in asthma. , 1998, American journal of respiratory and critical care medicine.

[11]  G. Town,et al.  Asthma control during long term treatment with regular inhaled salbutamol and salmeterol , 1998, Thorax.

[12]  J. FitzGerald,et al.  Effect of inhaled formoterol and budesonide on exacerbations of asthma. , 1998, The New England journal of medicine.

[13]  D. Postma,et al.  Effect of inhaled formoterol and budesonide on exacerbations of asthma. Formoterol and Corticosteroids Establishing Therapy (FACET) International Study Group. , 1997, The New England journal of medicine.

[14]  Phillips Yy,et al.  Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, November 1986. , 1987, The American review of respiratory disease.

[15]  Pieter,et al.  SalmeteroVfluticasone propionate ( 50 / 500 pg ) in combination in a Diskus @ inhaler ( Seretide @ ) is effective and safe in the treatment of steroid-dependent asthma , 2022 .