12 Sep

Effect of Long-term Salmeterol Therapy Compared With As-Needed Albuterol Use on Airway Hyperresponsiveness: Results

Significantly fewer patients withdrew from the salmeterol group than from the placebo group (34 vs 53 patients, respectively; p = 0.03). Reasons for withdrawal included lack of efficacy (salmeterol group, 5 patients; placebo group, 8 patients), adverse event (salmeterol group, 1 patient; placebo group, 4 patients), and failure to return (sal-meterol group, 4 patients; placebo group, 11 patients). Additionally, 54 patients (salmeterol group, 24 patients; placebo group, 30 patients) were withdrawn from the study because of protocol violations or because they were lost to follow-up.
Bronchial Hyperresponsiveness
The use of salmeterol significantly increased (p < 0.001) PD20 values when compared to placebo after 4, 12, and 24 weeks of treatment (Fig 1). Change (SEM) from baseline was 1.05 (0.13), 1.03 (0.14), and 1.00 (0.14) doubling doses of methacho-line after 4, 12, and 24 weeks of salmeterol treatment, respectively. In the placebo group, doubling dose changes of 0.14 (0.14), 0.48 (0.15), and 0.40 (0.17) were observed. PD20 values obtained 3 and 7 days posttreatment remained above baseline levels in both the salmeterol and placebo groups, and no significant differences were observed between groups. order yaz online

PEF Measurements
Salmeterol significantly increased mean morning PEF by 26.2 (2.5) L/min above baseline over weeks 1 through 24 when compared to an increase of 5.3 (2.0) L/min for placebo (p < 0.001; Fig 2). Mean morning PEF values over the posttreatment period remained 19.9 and 11.8 L/min, respectively, above baseline in the salmeterol and placebo groups. Similarly, the use of salmeterol significantly increased mean evening PEF values by 18.7 (2.1) L/min above baseline when compared to an increase of 6.4 (2.0) L/min for treatment with placebo (p < 0.001; Fig 2).
At baseline, mean evening to morning PEF variation was 23.9 (2.2) and 23.4 (2.6) L/min, respectively, in the salmeterol and placebo groups. Over weeks 1 through 24, mean PEF variation was reduced significantly to 14.9 (1.6) L/min in the salmeterol group compared with a mean increase to 24.8 (2.4) L/min in the placebo group (p < 0.001).

Figure 1. Change from baseline in bronchial hyperresponsiveness during and after treatment from methacholine challenge test. PD20 values are presented as geometric means. Treatment comparisons are based on ANOVA on change from baseline, controlling for investigator. * = significant difference from placebo.

Figure 1. Change from baseline in bronchial hyperresponsiveness during and after treatment from methacholine challenge test. PD20 values are presented as geometric means. Treatment comparisons are based on ANOVA on change from baseline, controlling for investigator.

Figure 2. Mean change from baseline in morning and evening PEF. Baseline is the average of the 7 days immediately prior to treatment day 1. Treatment comparisons are based on ANOVA on change from baseline, controlling for investigator.

Figure 2. Mean change from baseline in morning and evening PEF. Baseline is the average of the 7 days immediately prior to treatment day 1. Treatment comparisons are based on ANOVA on change from baseline, controlling for investigator.

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