This retrospective analysis compares the onset of relief from COPD symptoms after initiating therapy with either Advair Diskus 250/50 BID or ipratropium/albuterol 36/206mcg QID via MDI (IB/ALB).
Patient-recorded diary data was evaluated from two randomized, double-blind, parallel group trials of COPD patients (n=726) randomized to FSC or IB/ALB for 8 weeks. Patients were ≥40 years of age with symptomatic COPD, had a FEV1/FVC <0.7 and a FEV1 40 to 70% of predicted normal (baseline mean=43%), and did not use inhaled or oral corticosteriods for at least 30 days prior to randomization. Patients recorded a daily diary with AM peak expiratory flow (PEF), nighttime awakenings requiring albuterol, and day and sleep symptom scores using a Visual Analogue Scale (VAS). Data from treatment day 1 to day 7 were compared between treatment groups to evaluate the onset of COPD symptom relief.
Overall, symptom improvement was noted in both treatment groups, however, patients treated with Advair 250/50 consistently indicated early and significantly greater improvements in symptoms compared with IB/ALB. These patients perceived improvements following the significant increase in mean AM PEF starting at day 1 for Advair 250/50 (17.7 L/min) compared with IB/ALB (5.4 L/min) (p<0.001). The improvements seen early were sustained throughout the 8-week study period.
Patients perceive significantly greater improvement in COPD symptoms as early as day 1 after initiating treatment with Advair 250/50 BID compared to IB/ALB 36/206mcg QID.
Use of an inhaled corticosteroid and long acting beta-agonist together provides patient perceived improvement in COPD symptoms within one day of starting treatment. This may encourage patient compliance and therefore lead to improved efficacy.
Changes in FEV1 Responses From Day 1 to Week 8FSC (n=303)IB/ALB (N=299)Peak FEV1 change from baseline, mL51.5 (18.3%)-17.7 (-5.4%)FEV1AUC0–6, L-hr0.33 (22.7%)-0.22 (-14.2%)FEV1AUC0–4, L-hr0.25 (24.6%)-0.11 (-10.9%)FEV1AUC0–2, L-hr0.15 (26.7%)-0.03 (-5.9%)
K. Knobil, None.