Elsevier

Respiratory Medicine

Volume 107, Issue 4, April 2013, Pages 542-549
Respiratory Medicine

Influence of salmeterol/fluticasone via single versus separate inhalers on exacerbations in severe/very severe COPD

https://doi.org/10.1016/j.rmed.2012.12.020Get rights and content
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Summary

Background

Patients with severe or very severe chronic obstructive pulmonary disease (COPD) frequently suffer repeated exacerbations generating high health care utilization costs. Combined corticosteroid and bronchodilator treatment using a single inhaler might - via improved compliance - reduce exacerbation rates.

Objectives

Our aim was to obtain descriptive data on exacerbation rates in patients with severe or very severe COPD (GOLD Stages III and IV as per GOLD 2009 classification) receiving salmeterol xinafoate/fluticasone propionate via a single inhaler (SFC) or via separate inhalers (Sal/FP) in addition to individual existing therapy in order to investigate the potential benefit of a fixed combination device as compared with two separate devices due to potentially improved patients' compliance.

Methods

This prospective, randomized, open-label, parallel-group, multi-center, exploratory study was conducted in Germany in 2007–2009. Patients were required to have suffered ≥ 2 moderate/severe exacerbations in the preceding year.

Results

213 patients (SFC: 108 patients, Sal/FP: 105 patients) from 23 centers were evaluated. Approximately 25% of patients showed COPD Stage IV. On average patients had suffered 2.3 ± 0.6 moderate/severe exacerbations in the preceding year. The annual rate of moderate/severe exacerbations observed in the study was similar in both treatment groups (SFC: 0.86 ± 0.13; Sal/FP: 0.86 ± 0.14; exacerbation rate ratio SFC/Sal/FP: 1.00; p = 0.73; negative binomial model). Compliance was high and comparable in both groups. Besides COPD exacerbations, pneumonia (5.6%) and nasopharyngitis (5.2%) were the most common adverse events.

Conclusion

Observed exacerbation rates were lower than those reported at baseline. No substantial difference was observed between administration of salmeterol xinafoate/fluticasone propionate via a single inhaler and separate inhalers. Treatment was safe and well tolerated.

ClinicalTrials.gov Identifier: NCT00527826.

Keywords

COPD
Exacerbations rate
Health care utilization

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