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Original Research: COPD |

The Efficacy and Safety of Combination Salmeterol (50 μg)/Fluticasone Propionate (500 μg) Inhalation Twice Daily Via Accuhaler in Chinese Patients With COPD*

Jin-Ping Zheng, MD, FCCP; Lan Yang, MD; Ya Mei Wu, MD; Ping Chen, MD, FCCP; Zhong Guang Wen, MD; Wen-Jie Huang, MD; Yi Shi, MD; Chang-Zheng Wang, MD; Shao-Guang Huang, MD; Tie-ying Sun, MD; Guang-Fa Wang, MD; Sheng-Dao Xiong, MD; Nan-Shan Zhong, MD, FCCP
Author and Funding Information

*From the Guangzhou Institute of Respiratory Disease (Drs. Zheng and Zhong), First Affiliated Hospital of Guangzhou Medical College, Guangzhou, People’s Republic of China; First Affiliated Hospital (Dr. Yang), Xi’An Jiao Tong University, Xi’An, People’s Republic of China; First Affiliated Hospital (Dr. Wu), Chongqing Medical University, Chongqing, People’s Republic of China; Shenyang People’s Liberation Army General Hospital (Dr. Chen), Shenyang, People’s Republic of China; Beijing People’s Liberation Army 304 Hospital (Dr. Wen), Beijing, People’s Republic of China; Nanjing People’s Liberation Army General Hospital (Dr. Shi), Nanjing, People’s Republic of China; Xinqiao Hospital (Dr. C.-Z. Wang), Chongqin, People’s Republic of China; Ruijing Hospital (Dr. S.-G. Huang), Shanghai, People’s Republic of China; Beijing Hospital (Dr. Sun), Beijing, People’s Republic of China; First Affiliated Hospital of Beijing University (Dr. G.-F. Wang), Beijing, People’s Republic of China; Tongji Hospital (Dr. Xiong), Wuhan, People’s Republic of China; and Guangzhou People’s Liberation Army General Hospital (Dr. W.-J. Huang), Guangzhou, People’s Republic of China.

Correspondence to: N. S. Zhong, MD, FCCP, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical College, Guangzhou 510120, People’s Republic of China; e-mail: nanshan@vip.163.com



Chest. 2007;132(6):1756-1763. doi:10.1378/chest.06-3009
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Background: Few studies of the efficacy and safety of therapy with combinations of salmeterol/fluticasone propionate (SFCs) have been conducted in Chinese patients with COPD, and the benefits of combination therapy in nonsmoking patients with COPD are, to our knowledge, not known.

Study objectives: The aims were to establish the efficacy and tolerability of the therapy with SFC (salmeterol, 50 μg/fluticasone, 500 μg, twice daily) in the management of Chinese COPD patients and to investigate the effectiveness of SFC in nonsmokers with COPD.

Methods and patients: This was a randomized, double-blind, placebo-controlled, parallel-group, multicenter study. Changes in prebronchodilator and postbronchodilator FEV1, quality of life determined by the St. George Respiratory Questionnaire (SGRQ) scores, relief bronchodilator use, nighttime awakenings, and frequency of exacerbations of COPD were measured in patients randomized to receive SFC (n = 297) or placebo (n = 148). Never-smokers, former smokers, and current smokers accounted for 11.7%, 66.7%, and 21.6%, respectively, of the study population.

Results: After 24 weeks, the mean changes in prebronchodilator and postbronchodilator FEV1 were 180 mL (95% confidence interval [CI], approximately 91 to 268; p < 0.001) and 65 mL (95% CI, approximately 14 to 115; p = 0.012), respectively, greater for the SFC group than that for the placebo group. The differences in response to treatment were significant (all p < 0.0001) in former or current smokers but not in never-smokers (p > 0.05). The mean improvement in the total SGRQ score for the SFC group was 5.74 (p < 0.01) greater than that for the placebo group. SFC significantly reduced the frequency of nighttime awakenings and the use of relief bronchodilator. The adjusted ratio of exacerbations of COPD for the SFC group relative to the placebo group was 0.61 (95% CI, approximately 0.45 to 0.84; p < 0.01). There were no significant differences between the SFC and placebo groups in safety measures.

Conclusions: SFC therapy achieved sustained improvement in lung function, quality of life, and control of symptoms, and was well tolerated in Chinese patients. Greater improvements in lung function were found only for COPD patients with a history of smoking.

Trial registration: http://ctr.gsk.co.uk/Summary/fluticasone_salmeterol/studylist.asp Identifier: No. SCO100540.

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