Salmeterol improves quality of life in patients with asthma requiring inhaled corticosteroids

• Published in: Journal of allergy and clinical immunology Vol. 101; no. 2; pp. 188 - 195
• Main Authors: Kemp, James P., Cook, David A., Incaudo, Gary A., Corren, Jonathan, Kalberg, Chris, Emmett, Amanda, Cox, Fred M., Rickard, Kathleen
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.02.1998; Elsevier
• Subjects: asthma; Biological and medical sciences; Medical sciences; pharmacoeconomics; Pharmacology. Drug treatments; quality of life; Respiratory system; Salmeterol; PEF; asthma; AQLQ; quality of life; pharmacoeconomics; Salmeterol; Human; Corticosteroid; Drug combination; Respiratory disease; Bronchodilator; Treatment efficiency; Antiinflammatory agent; β2-Adrenergic receptor; β-Adrenergic receptor agonist; Asthma; Inhalation; Quality of life; Chemotherapy; Treatment; Salbutamol; Obstructive pulmonary disease
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/S0091-6749(98)70383-5

Background: Traditional clinical outcomes have demonstrated that salmeterol improves pulmonary function and reduces asthma symptoms. However, they do not evaluate how patients perceive the effect of therapeutic intervention on day-to-day functioning and well-being. Objective: We sought to evaluate the impact of salmeterol on disease-specific quality of life with the Asthma Quality-of-Life Questionnaire, as well as the efficacy and safety of salmeterol in patients with stable asthma who were symptomatic despite daily use of inhaled corticosteroids. Methods: This was a randomized, double-blind, placebo-controlled, parallel-group study of 506 patients. Patients were treated with 42 μg salmeterol or placebo twice daily for 12 weeks delivered through a metered dose inhaler. Results: Mean change from baseline in asthma quality-of-life scores was significantly greater ( p ≤ 0.006) after 12 weeks of treatment with salmeterol compared with placebo (“as-needed” albuterol) in global scores (1.08 vs 0.61) and individual domains (activity limitations, 0.91 vs 0.54; asthma symptoms, 1.28 vs 0.71; emotional function, 1.17 vs 0.65; and environmental exposure, 0.84 vs 0.47). Patients treated with salmeterol experienced significantly greater improvements from baseline to week 12 compared with placebo in FEV 1 (0.42 L vs 0.15 L, p < 0.001), morning peak expiratory flow (47 L/min vs 14 L/min, p  < 0.001), evening peak expiratory flow (29 L/min vs 11 L/min, p < 0.001), and asthma symptom scores (daytime scores reduced by 0.55 vs 0.30, p < 0.001). Patients treated with salmeterol used significantly less supplemental albuterol (reduced by 3 puffs/day vs 1 puff/day, p < 0.001). Conclusion: Salmeterol provided significantly greater improvement in quality-of-life outcomes in patients whose asthma symptoms are not well controlled with inhaled corticosteroids. These results demonstrate that the benefits of salmeterol are not limited to conventional clinical measures of efficacy. (J Allergy Clin Immunol 1998;101:185-95.)