07 Sep

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

Effect of Long-term Salmeterol Therapy Compared With As-Needed Albuterol Use on Airway HyperresponsivenessCurrent guidelines for the diagnosis and management of asthma recognize asthma as a chronic inflammatory disease of the airways in which many cells and cellular elements play a role. In particular, mast cells, eosinophils, T lymphocytes, neutrophils, and epithelial cells have been identified as important contributors. Variable airway bronchoconstriction, respiratory symptoms, and bronchial hyperresponsiveness characterize the disease. inhalers for asthma

Early intervention with inhaled corticosteroid therapy is emphasized for patients with persistent asthma. For patients that remain symptomatic while using inhaled corticosteroids, adding salmeterol, a long-acting bronchodila-tor, is recommended for long-term control of symp-toms. Based on an extended duration of action of > 12 h, salmeterol is classified as a controller medication in current asthma management guidelines. Clinical studies evaluating the combined use of inhaled corticosteroids and salmeterol have shown that this regimen is more effective in providing overall improvement in pulmonary function and symptom control when compared to doubling the dose of inhaled corticosteroids.
Previous studies have shown reduced bronchopro-tective effects of salmeterol against methacholine challenge in patients independent of the use of inhaled corticosteroids. The clinical relevance of this effect is unclear, particularly as levels of bron-choprotection remained significantly above control levels, and no loss of bronchodilatory effect or control of asthma symptoms was observed with regular salmeterol treatment. However, because the studies showing reduced bronchoprotective effect of salmeterol were conducted for no longer than 8 weeks, long-term studies are necessary to determine whether a progressive reduction in bronchoprotec-tion occurs and leads to clinical instability of patients’ asthma.
In this study, the effects of long-term regular use of 42 ^g inhaled salmeterol aerosol on bronchial hyperresponsiveness were investigated during and after treatment in patients with moderate persistent asthma who were not using inhaled corticosteroids. Additional clinical outcome measures included pulmonary function tests, symptom assessment, nocturnal awakenings, and supplemental albuterol use.

Categories: Airway
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