Salmeterol and oral steroid treatment
Current international guidelines for asthma management recommend the introduction of supportive long acting bronchodilator therapy to be used in conjunction with maximal levels of inhaled corticosteroids, particularly before the introduction of long term oral corticosteroid therapy. A study in severe asthmatics, who were under consideration for the introduction of oral corticosteroid treatment, demonstrated that the addition of Salmeterol to maximal doses of inhaled corticosteroids significantly improved the overall level of asthma control so that in some patients the need to employ long term oral corticosteroid therapy was delayed or prevented.
Salmeterol introduced earlier in milder forms of asthma offers an additional option to increasing the level of inhaled corticosteroid therapy and further more symptom control can be maintained with lower levels of anti-inflammatory medication. The effectiveness of Salmeterol in influencing the level of corticosteroid requirement at different stages of the asthmatic process is a valuable therapeutic asset and promotes a more flexible approach to drug therapy with symptom control achieved with lower levels of anti-inflammatory agent.
KeywordsAsthma Control Peak Expiratory Flow Rate Beclomethasone Dipropionate British Thoracic Society Inhale Corticosteroid Therapy
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- 1.International consensus report on the diagnosis and management of asthma (1992) Clinical and Experimental Allergy 22 [Suppl]: 1–72Google Scholar
- 2.British Thoracic Society and others (1993) Guidelines on the management of asthma. Thprax 48 [Suppl]: S 1-S 24Google Scholar
- 3.Global Initiative for Asthma. Publication No 95–3659, January 1995. National Institutes of Health.Google Scholar
- 4.G Boyd on behalf of a UK Study Group (1995) Salmeterol xinafoate in asthma patients under consideration for maintenance oral corticosteroid therapy. Eur Respir J 8: 1494–1498Google Scholar
- 5.Woolcock A, Lundback BO, Ringdal NILS, Jacques LA (1996) Comparison of addition of salmeterol to inhaled steroids with doubling of the dose of inhaled steroids. Am J Crit Care Medicine 153: 1481–8Google Scholar
- 7.Tattersfield AE, Wilding P, Thompson-Coon J, Clark M, Lewis S (1996) Efficacy and safety of long term treatment with Salmeterol in Adults with Asthma. Am J Respir Crit Care Medicine 53: A66Google Scholar
- 8.Pedersen B, Fauischou P, Madsen F, Viskum K, Wilcke T, Dahl R (1996) Salmeterol treatment reduces the need for inhaled steroids in steroid dependent asthmatics — a randomised, double-blind, placebo-controlled parallel group study. Eur Respir 9 [Suppl 23]: 505Google Scholar