Comparison of salmeterol/fluticasone propionate (FP) combination with FP+sustained release theophylline in moderate asthma patients.

Author(s): Adachi M, Aizawa H, Ishihara K, Ohta K, Sano Y, Taniguchi H, Nakashima M

Affiliation(s): First Department of Internal Medicine, School of Medicine, Showa University, Tokyo, Japan.

Publication date & source: 2008-07, Respir Med., 102(7):1055-64. Epub 2008 Apr 3.

Publication type:

OBJECTIVES: To compare the efficacy and safety of the salmeterol/fluticasone propionate combination product with concurrent sustained release theophylline plus fluticasone propionate in adult Japanese patients with persistent asthma. DESIGN: Multicentre, randomised, double-blind, double-dummy, parallel-group study. PATIENTS AND INTERVENTIONS: Three hundred and eighty-three asthmatic patients receiving sustained release theophylline 200-400mg/day entered the study and were randomised to receive either salmeterol/fluticasone propionate combination (SFC) 50mug/250mug+1 placebo tablet, fluticasone propionate 250mug+1 sustained release theophylline 200mg (SR-T+FP), twice daily for 8 weeks. RESULTS: The adjusted mean change morning peak expiratory flow (PEF) over 8 weeks was 29.8L/min in the SFC group and 16.3L/min in the SR-T+FP group, with a treatment difference of 13.4L/min (p=0.0004). SFC improved evening PEF, FEV(1), V (50) and V (25) at the completion of treatment to a greater extent than SR-T+FP (all p<0.05). A higher percentage of patients on SFC were symptom free (p=0.0286) and rescue free (ns) than those on SR-T+FP. There was not a statistically significant difference between treatments in symptom scores. Both treatments were well tolerated. CONCLUSIONS: The finding that SFC was associated with greater improvements in lung function than SR-T+FP, a commonly employed treatment for asthmatic patients in Japan, suggests that SFC should be the preferred therapeutic option in these patients.