The efficacy and safety of combination salmeterol (50 μg)/fluticasone propionate (500 μg) inhalation twice daily via accuhaler in Chinese patients with COPD

被引:43
作者
Zheng, Jin-Ping [1 ]
Yang, Lan [2 ]
Wu, Ya Mei [3 ]
Chen, Ping [4 ]
Wen, Zhong Guang [5 ]
Huang, Wen-Jie [12 ]
Shi, Yi [6 ]
Wang, Chang-Zheng [7 ]
Huang, Shao-Guang [8 ]
Sun, Tie-ying [9 ]
Wang, Guang-Fa [10 ]
Xiong, Sheng-Dao [11 ]
Zhong, Nan-Shan
机构
[1] First Affiliated Hosp Guangzhou Med Coll, Guangzhou Inst Resp Dis, Guangzhou 510120, Peoples R China
[2] Xi An Jiao Tong Univ, Affiliated Hosp 1, Xian, Peoples R China
[3] Chongqing Med Univ, Affiliated Hosp 1, Chongqing, Peoples R China
[4] Shenyang Peoples Liberat Army Gen Hosp, Shenyang, Peoples R China
[5] Beijing Peoples Liberat Army 304 Hosp, Beijing, Peoples R China
[6] Nanjing Peoples Liberat Army Gen Hosp, Nanjing, Peoples R China
[7] Xinqiao Hosp, Chongqing, Peoples R China
[8] Ruijing Hosp, Shanghai, Peoples R China
[9] Beijing Hosp, Beijing, Peoples R China
[10] Beijing Univ, Affiliated Hosp 1, Beijing 100871, Peoples R China
[11] Tongji Hosp, Wuhan, Peoples R China
[12] Guangzhou Peoples Liberat Army Gen Hosp, Guangzhou, Peoples R China
关键词
COPD; fluticasone propionate; inhaled corticosteroid; long-acting beta(2)-agonist; salmeterol;
D O I
10.1378/chest.06-3009
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Few studies of the efficacy and safety of therapy with combinations of salmeterol/ fluticasone propionate (SFCs) have been conducted in Chinese patients with COPD, and the benefits of combination therapy in nonsmoking patients with COPD are, to our knowledge, not known. Study objectives: The aims were to establish the efficacy and tolerability of the therapy with SFC (salmeterol, 50 mu g(fluticasone, 500 mu g, twice daily) in the management of Chinese COPD patients and to investigate the effectiveness of SFC in nonsmokers with COPD. Methods and patients: This was a randomized, double-blind, placebo-controlled, parallel-group, multicenter study. Changes in prebronchodilator and postbronchodilator FEV1, quality of life determined by the St. George Respiratory Questionnaire (SGRQ) scores, relief bronchodilator use, nighttime awakenings, and frequency of exacerbations of COPD were measured in patients randomized to receive SFC (n = 297) or placebo (n = 148). Never-smokers, former smokers, and current smokers accounted for 11.7%, 66.7%, and 21.6%, respectively, of the study population. Results: After 24 weeks, the mean changes in prebronchodilator and postbronchodilator FEV1 were 180 mL (95% confidence interval [Cl], approximately 91 to 268; p < 0.001) and 65 mL (95% CI, approximately 14 to 115; p = 0.012), respectively, greater for the SFC group than that for the placebo group. The differences in response to treatment were significant (all p < 0.0001) in former or current smokers but not in never-smokers (p > 0.05). The mean improvement in the total SGRQ score for the SFC group was 5.74 (p < 0.01) greater than that for the placebo group. SFC significantly reduced the frequency of nighttime awakenings and the use of relief bronchodilator. The adjusted ratio of exacerbations of COPD for the SFC group relative to the placebo group was 0.61 (95% CI, approximately 0.45 to 0.84; p < 0.01). There were no significant differences between the SFC and placebo groups in safety measures. Conclusions: SFC therapy achieved sustained improvement in lung function, quality of life, and control of symptoms, and was well tolerated in Chinese patients. Greater improvements in lung function were found only for COPD patients with a history of smoking. Trial registration: http://ctr.gsk.co.uk/Summairy/fluticasone-salmeterol/studylist.asp Identifier. No. SCO100540.
引用
收藏
页码:1756 / 1763
页数:8
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