The comparison of clinical efficacy of formoterol and fluticasone versus salmeterol and fluticasone in patients of bronchial asthma
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20181640Keywords:
Asthma, LABA, ICSAbstract
Background: Fixed-dose combinations of Inhaled corticosteroids (ICS) and Long acting beta agonist (LABA) are established and widely used treatment for bronchial asthma when ICSs as monotherapy are ineffective. This study attempted to compare the efficacy of salmeterol and fluticasone with formoterol (newer LABA) and fluticasone in patients of bronchial asthma.
Methods: An open label, randomized, prospective, parallel and comparative study of eight-week duration was conducted on 80 patients of bronchial asthma, with the collaboration of Department of pharmacology and Department of Tuberculosis and Chest Diseases Hospital, Government medical college, Amritsar. Patients in Group A were treated with 2 actuations of Formoterol and Fluticasone (6/125µg) twice daily and group B patients were treated with 2 actuations of Salmeterol and Fluticasone (50/125µg) twice daily for 8 weeks with metered dose inhaler (MDI). Patients in group A and B were assessed on day zero, 4 weeks and 8 weeks for clinical assessment and computerized spirometry for FVC, FEV1, FEV1/FVC and PEFR.
Results: In group A mean±SD of FEV1 statistically significantly increased (<0.001) after eight week of therapy (1.50±0.12) from its baseline values (1.34±0.11). Similarly, in group B mean ± SD of FEV1 statistically significantly increased (<0.001) after eight weeks (1.48±0.13) from its baseline values (1.36±0.12). There was statistically significant (<0.001) improvement in other parameters of spirometry in patients of both the groups.
Conclusions: It was observed that both the combination of Fluticasone + Formoterol and Fluticasone + Salmeterol are effective in the treatment of bronchial asthma.
References
Kasper DL, editor. Harrison’s principles of internal medicine. 19th edition / editors, Dennis L. Kasper, MD, William Ellery Channing, Professor of Medicine, Professor of Microbiology, Department of Microbiology and Immunobiology, Harvard Medical School, Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, Massachusetts [and five others]. New York: McGraw Hill Education; 2015:1.
Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald M, et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J. 2008 Jan;31(1):143-78.
Berger WE, Ford LB, Mahr T, Nathan RA, Crim C, Edwards L, et al. Efficacy and safety of fluticasone propionate 250 microg administered once daily in patients with persistent asthma treated with or without inhaled corticosteroids. Ann Allergy Asthma Immunol Off Publ Am Coll Allergy Asthma Immunol. 2002 Oct;89(4):393-9.
Sovijarvi A, Haahtela T, Ekroos H, Lindqvist A, Saarinen A, Poussa T, et al. Sustained reduction in bronchial hyperresponsiveness with inhaled fluticasone propionate within three days in mild asthma: time course after onset and cessation of treatment. Thorax. 2003 Jun;58(6):500-4.
Crim C, Pierre LN, Daley-Yates PT. A review of the pharmacology and pharmacokinetics of inhaled fluticasone propionate and mometasone furoate. Clin Ther. 2001 Sep;23(9):1339-54.
Daley-Yates PT, Parkins DA. Systemic bioavailability of hydrofluoroalkane formulations containing fluticasone propionate and salmeterol. Br J Clin Pharmacol. 2011 Aug;72(2):353-4.
Bodzenta-Lukaszyk A, Dymek A, McAulay K, Mansikka H. Fluticasone/formoterol combination therapy is as effective as fluticasone/salmeterol in the treatment of asthma but has a more rapid onset of action: an open-label, randomized study. BMC Pulm Med. 2011 May 23;11:28.
Tan RA, Corren J. Clinical utility and development of the fluticasone/formoterol combination formulation (Flutiform®) for the treatment of asthma. Drug Des Devel Ther. 2014 Sep 30;8:1555-61.
Shapiro G, Lumry W, Wolfe J, Given J, White MV, Woodring A, et al. Combined salmeterol 50 microg and fluticasone propionate 250 microg in the diskus device for the treatment of asthma. Am J Respir Crit Care Med. 2000 Feb;161(2 Pt 1):527-34.
Sirisha GM. Comparison of Safety and Action of Salmeterol and Formoterol in Combination with Fluticasone Propionate in Asthma Patients. Sch Acad J Pharm. 2013;26:452-7.
