Salmeterol/fluticasone treatment reduces circulating C-reactive protein level in
patients with stable chronic obstructive pulmonary disease.
Author(s): Tang YJ, Wang K, Yuan T, Qiu T, Xiao J, Yi Q, Feng YL.
Affiliation(s): Department of Respiratory Medicine, West China Hospital, Sichuan University,
Chengdu, Sichuan 610041, China.
Publication date & source: 2010, Chin Med J (Engl). , 123(13):1652-7
BACKGROUND: Evidence suggests that systemic inflammation may play an important
role in the progression and morbidity of chronic obstructive pulmonary disease.
It remains controversial whether inhaled corticosteroid in combination with a
long-acting beta(2)-adrenoceptor agonist can attenuate systemic inflammation. We
evaluated the effect of salmeterol/fluticasone propionate on circulating
C-reactive protein level in stable chronic obstructive pulmonary disease
patients.
METHODS: An open-label clinical trial was conducted to recruit 122 outpatients
with stable moderate-to-severe chronic obstructive pulmonary disease from
department of respiratory medicine in two teaching hospitals between June 2007
and March 2008. Patients were randomized into two groups (1:1) to receive either
the combination of 50 microg salmeterol and 500 microg fluticasone twice daily (n
= 61), or the combination of 206 microg albuterol and 36 microg ipratropium q.i.d
(n = 61) over 6 months. Circulating C-reactive protein concentrations were
measured before randomization and during the follow-up. The efficacy of treatment
was also assessed by spirometry, as well as health status and dyspnea score at
baseline and after 6-month treatment.
RESULTS: Baseline characteristics of two groups were similar. Compared with
ipratropium/albuterol, the combination of salmeterol/fluticasone significantly
reduced circulating level of C-reactive protein (-1.73 vs. 0.08 mg/L,
respectively, P < 0.05) after 6-month treatment. Forced expiratory volume in one
second (FEV(1)) and health status also improved significantly in
salmeterol/fluticasone group compared with ipratropium/albuterol.
Salmeterol/fluticasone treatment subjects who had a decrease of circulating
C-reactive protein level had a significant improvement in FEV(1) and St George's
Respiratory Questionnaire total scores compared with those who did not (185 vs.
83 ml and -5.71 vs. -1.79 units, respectively, both P < 0.01).
CONCLUSION: Salmeterol/fluticasone treatment reduced circulating C-reactive
protein concentration in clinically stable moderate-to-severe chronic obstructive
pulmonary disease patients after 6-month treatment.
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