Introduction: Airway inflammation is a known pathological feature of chronic obstructive pulmonary disease (COPD). We examined the effect of inhaled salmeterol, alone and in combination with fluticasone propionate, on the management of patients with COPD.
Methods: Forty male COPD patients were randomly divided into two groups; group 1 (n=20) were treated with long-acting ß2-agonist, and group 2 (n=20) with long-acting ß2-agonist and inhaled glucocoticoid each day for 3 months. Pulmonary function tests (PFTs), including forced vital capacity (FVC), forced expiratory volume in 1s (FEV1) and peak expiratory flow (PEF), were measured at the beginning, 1 and 2 months after treatment and at the end of the study. The frequency of using inhaled salbutamol/day and the 6-min walk distance were also measured at four different visits. The frequency of exacerbation was also recorded during the 90-day treatment period in the two groups.
Results: FEV(1) , FVC and PEF were significantly higher after 30 days of treatment with fluticasone propionate (mean change from baseline in group 2: 155mL, 200mL and 70L/s, respectively; P<0.001). Six-minute walk distance also increased significantly (mean change from baseline: 160 m; P < 0.001), and there was a 70%-80% reduction in the use of inhaled salbutamol (P<0.001). All improvements were maintained over the remainder of the study period. Exacerbations over the 90-day treatment period were significantly fewer than in the same 90-day period in the previous year (2.8±0.7 vs 0.8±0.9; P<0.001). In contrast, only PEF increased significantly with treatment in group 1 (salmeterol treatment alone).
Conclusions: These results indicated that inhaled corticosteroids may be beneficial in some patients with COPD.
© 2010 Blackwell Publishing Ltd.