מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – In symptomatic patients with mild-to-moderate asthma, combined treatment with low-dose salmeterol/fluticasone is as effective as therapy with a fourfold higher dose of budesonide, according to a report in Clinical Drug Investigations for October.
Dr. Gunnar Johansson from Nyby Vardcentral, Uppsala, Sweden, and colleagues randomly assigned 349 symptomatic asthmatics to salmeterol/fluticasone 50/100 µg twice daily or to budesonide 400 µg twice daily for 12 weeks.
For patients receiving combination therapy with salmeterol/fluticasone there was a significantly greater increase in mean morning (p = 0.022) and evening (p = 0.008) peak expiratory flow compared with patients receiving budesonide, the research group found.
At the end of the trial, patients in the salmeterol/fluticasone group had a mean morning PEF of 426 L/min compared with 415 L/min among those in the budesonide group. Mean evening PEF was 435 L/min in the combined therapy group compared with 424 L/min in the budesonide group, Dr. Johansson's team reports.
Treatment with salmeterol/fluticasone was significantly better from the first week of the trial in both morning (p < 0.001) and evening (p < 0.002) peak expiratory flow compared with budesonide therapy. Both treatments were well tolerated with no difference in improved symptom scores, use of rescue medication, clinic spirometry and exacerbations, the investigators add.
"The use of combination therapy permits asthma control to be achieved at a lower corticosteroid dose in accordance with asthma guidelines, and without the need for an additional inhaler," Dr. Johansson and colleagues conclude.
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