Control of airway inflammation maintained at a lower steroid dose with 100/50 μg of fluticasone propionate/salmeterol

Nizar N. Jarjour, Susan J. Wilson, Steven M. Koenig, Michel Laviolette, Wendy C. Moore, W. Bruce Davis, Dennis E. Doherty, Qutayba Hamid, Elliott Israel, Mani S. Kavuru, Joe W. Ramsdell, Donald P. Tashkin, Donna S. Reilly, Steven W. Yancey, Lisa D. Edwards, John L. Stauffer, Paul M. Dorinsky, Ratko Djukanovic

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background: Inhaled corticosteroids (ICSs) have been shown to reverse epithelial damage and decrease lamina reticularis thickness in patients with asthma. Objective: This study investigated whether clinical asthma control and airway inflammation could be maintained after switching therapy from medium-dose fluticasone propionate (FP) to low-dose FP administered with the long-acting β 2-agonist (LABA) salmeterol. Methods: Eighty-eight subjects (age, ≥18 years) who, during open-label screening, demonstrated improved asthma control after an increase from 100 μg of FP twice daily to 250 μg of FP twice daily were randomized to receive 100/50 μg of FP/salmeterol through a Diskus inhaler (GlaxoSmithKline, Research Triangle Park, NC) twice daily or continue 250 μg of FP twice daily through a Diskus inhaler for 24 weeks. Clinical outcomes were monitored, and bronchial biopsy specimens and bronchoalveolar lavage fluid were obtained before and after 24 weeks of treatment. Results: There were no significant differences between treatments with respect to eosinophils in the bronchial mucosa and bronchoalveolar lavage fluid; mucosal mast cells, neutrophils, or CD3 +, CD4 +, CD8 +, or CD25 + T lymphocytes; or concentration of mediators (GM-CSF, IL-8, and eosinophil cationic protein). The 2 treatments were not different with respect to lamina reticularis thickness. Consistent with the airway inflammatory measures, clinical and physiologic measures of asthma control were also similar. Conclusion: This study demonstrates that control of asthma and airway inflammation is maintained over the 24-week treatment period when patients requiring a medium-dose ICS are switched to a lower-dose ICS with a LABA. Clinical implications: A lower-dose ICS with a LABA is effective in controlling inflammation and providing clinical asthma control, confirming current guideline recommendations.

Original languageEnglish (US)
Pages (from-to)44-52
Number of pages9
JournalJournal of Allergy and Clinical Immunology
Volume118
Issue number1
DOIs
StatePublished - Jul 1 2006

Fingerprint

Airway Management
Asthma
Steroids
Inflammation
Adrenal Cortex Hormones
Bronchoalveolar Lavage Fluid
Nebulizers and Vaporizers
Eosinophil Cationic Protein
Therapeutics
Granulocyte-Macrophage Colony-Stimulating Factor
Interleukin-8
Eosinophils
Mast Cells
Salmeterol Xinafoate Drug Combination Fluticasone Propionate
Mucous Membrane
Neutrophils
Fluticasone
Guidelines
T-Lymphocytes
Biopsy

Keywords

  • Fluticasone propionate
  • biopsy
  • bronchoalveolar lavage
  • eosinophils
  • salmeterol

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Control of airway inflammation maintained at a lower steroid dose with 100/50 μg of fluticasone propionate/salmeterol. / Jarjour, Nizar N.; Wilson, Susan J.; Koenig, Steven M.; Laviolette, Michel; Moore, Wendy C.; Davis, W. Bruce; Doherty, Dennis E.; Hamid, Qutayba; Israel, Elliott; Kavuru, Mani S.; Ramsdell, Joe W.; Tashkin, Donald P.; Reilly, Donna S.; Yancey, Steven W.; Edwards, Lisa D.; Stauffer, John L.; Dorinsky, Paul M.; Djukanovic, Ratko.

In: Journal of Allergy and Clinical Immunology, Vol. 118, No. 1, 01.07.2006, p. 44-52.

Research output: Contribution to journalArticle

Jarjour, NN, Wilson, SJ, Koenig, SM, Laviolette, M, Moore, WC, Davis, WB, Doherty, DE, Hamid, Q, Israel, E, Kavuru, MS, Ramsdell, JW, Tashkin, DP, Reilly, DS, Yancey, SW, Edwards, LD, Stauffer, JL, Dorinsky, PM & Djukanovic, R 2006, 'Control of airway inflammation maintained at a lower steroid dose with 100/50 μg of fluticasone propionate/salmeterol', Journal of Allergy and Clinical Immunology, vol. 118, no. 1, pp. 44-52. https://doi.org/10.1016/j.jaci.2006.03.043
Jarjour, Nizar N. ; Wilson, Susan J. ; Koenig, Steven M. ; Laviolette, Michel ; Moore, Wendy C. ; Davis, W. Bruce ; Doherty, Dennis E. ; Hamid, Qutayba ; Israel, Elliott ; Kavuru, Mani S. ; Ramsdell, Joe W. ; Tashkin, Donald P. ; Reilly, Donna S. ; Yancey, Steven W. ; Edwards, Lisa D. ; Stauffer, John L. ; Dorinsky, Paul M. ; Djukanovic, Ratko. / Control of airway inflammation maintained at a lower steroid dose with 100/50 μg of fluticasone propionate/salmeterol. In: Journal of Allergy and Clinical Immunology. 2006 ; Vol. 118, No. 1. pp. 44-52.
@article{11ddb7e030e449299c95ce8d252959fb,
title = "Control of airway inflammation maintained at a lower steroid dose with 100/50 μg of fluticasone propionate/salmeterol",
abstract = "Background: Inhaled corticosteroids (ICSs) have been shown to reverse epithelial damage and decrease lamina reticularis thickness in patients with asthma. Objective: This study investigated whether clinical asthma control and airway inflammation could be maintained after switching therapy from medium-dose fluticasone propionate (FP) to low-dose FP administered with the long-acting β 2-agonist (LABA) salmeterol. Methods: Eighty-eight subjects (age, ≥18 years) who, during open-label screening, demonstrated improved asthma control after an increase from 100 μg of FP twice daily to 250 μg of FP twice daily were randomized to receive 100/50 μg of FP/salmeterol through a Diskus inhaler (GlaxoSmithKline, Research Triangle Park, NC) twice daily or continue 250 μg of FP twice daily through a Diskus inhaler for 24 weeks. Clinical outcomes were monitored, and bronchial biopsy specimens and bronchoalveolar lavage fluid were obtained before and after 24 weeks of treatment. Results: There were no significant differences between treatments with respect to eosinophils in the bronchial mucosa and bronchoalveolar lavage fluid; mucosal mast cells, neutrophils, or CD3 +, CD4 +, CD8 +, or CD25 + T lymphocytes; or concentration of mediators (GM-CSF, IL-8, and eosinophil cationic protein). The 2 treatments were not different with respect to lamina reticularis thickness. Consistent with the airway inflammatory measures, clinical and physiologic measures of asthma control were also similar. Conclusion: This study demonstrates that control of asthma and airway inflammation is maintained over the 24-week treatment period when patients requiring a medium-dose ICS are switched to a lower-dose ICS with a LABA. Clinical implications: A lower-dose ICS with a LABA is effective in controlling inflammation and providing clinical asthma control, confirming current guideline recommendations.",
keywords = "Fluticasone propionate, biopsy, bronchoalveolar lavage, eosinophils, salmeterol",
author = "Jarjour, {Nizar N.} and Wilson, {Susan J.} and Koenig, {Steven M.} and Michel Laviolette and Moore, {Wendy C.} and Davis, {W. Bruce} and Doherty, {Dennis E.} and Qutayba Hamid and Elliott Israel and Kavuru, {Mani S.} and Ramsdell, {Joe W.} and Tashkin, {Donald P.} and Reilly, {Donna S.} and Yancey, {Steven W.} and Edwards, {Lisa D.} and Stauffer, {John L.} and Dorinsky, {Paul M.} and Ratko Djukanovic",
year = "2006",
month = "7",
day = "1",
doi = "10.1016/j.jaci.2006.03.043",
language = "English (US)",
volume = "118",
pages = "44--52",
journal = "Journal of Allergy and Clinical Immunology",
issn = "0091-6749",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - Control of airway inflammation maintained at a lower steroid dose with 100/50 μg of fluticasone propionate/salmeterol

AU - Jarjour, Nizar N.

AU - Wilson, Susan J.

AU - Koenig, Steven M.

AU - Laviolette, Michel

AU - Moore, Wendy C.

AU - Davis, W. Bruce

AU - Doherty, Dennis E.

AU - Hamid, Qutayba

AU - Israel, Elliott

AU - Kavuru, Mani S.

AU - Ramsdell, Joe W.

AU - Tashkin, Donald P.

AU - Reilly, Donna S.

AU - Yancey, Steven W.

AU - Edwards, Lisa D.

AU - Stauffer, John L.

AU - Dorinsky, Paul M.

AU - Djukanovic, Ratko

PY - 2006/7/1

Y1 - 2006/7/1

N2 - Background: Inhaled corticosteroids (ICSs) have been shown to reverse epithelial damage and decrease lamina reticularis thickness in patients with asthma. Objective: This study investigated whether clinical asthma control and airway inflammation could be maintained after switching therapy from medium-dose fluticasone propionate (FP) to low-dose FP administered with the long-acting β 2-agonist (LABA) salmeterol. Methods: Eighty-eight subjects (age, ≥18 years) who, during open-label screening, demonstrated improved asthma control after an increase from 100 μg of FP twice daily to 250 μg of FP twice daily were randomized to receive 100/50 μg of FP/salmeterol through a Diskus inhaler (GlaxoSmithKline, Research Triangle Park, NC) twice daily or continue 250 μg of FP twice daily through a Diskus inhaler for 24 weeks. Clinical outcomes were monitored, and bronchial biopsy specimens and bronchoalveolar lavage fluid were obtained before and after 24 weeks of treatment. Results: There were no significant differences between treatments with respect to eosinophils in the bronchial mucosa and bronchoalveolar lavage fluid; mucosal mast cells, neutrophils, or CD3 +, CD4 +, CD8 +, or CD25 + T lymphocytes; or concentration of mediators (GM-CSF, IL-8, and eosinophil cationic protein). The 2 treatments were not different with respect to lamina reticularis thickness. Consistent with the airway inflammatory measures, clinical and physiologic measures of asthma control were also similar. Conclusion: This study demonstrates that control of asthma and airway inflammation is maintained over the 24-week treatment period when patients requiring a medium-dose ICS are switched to a lower-dose ICS with a LABA. Clinical implications: A lower-dose ICS with a LABA is effective in controlling inflammation and providing clinical asthma control, confirming current guideline recommendations.

AB - Background: Inhaled corticosteroids (ICSs) have been shown to reverse epithelial damage and decrease lamina reticularis thickness in patients with asthma. Objective: This study investigated whether clinical asthma control and airway inflammation could be maintained after switching therapy from medium-dose fluticasone propionate (FP) to low-dose FP administered with the long-acting β 2-agonist (LABA) salmeterol. Methods: Eighty-eight subjects (age, ≥18 years) who, during open-label screening, demonstrated improved asthma control after an increase from 100 μg of FP twice daily to 250 μg of FP twice daily were randomized to receive 100/50 μg of FP/salmeterol through a Diskus inhaler (GlaxoSmithKline, Research Triangle Park, NC) twice daily or continue 250 μg of FP twice daily through a Diskus inhaler for 24 weeks. Clinical outcomes were monitored, and bronchial biopsy specimens and bronchoalveolar lavage fluid were obtained before and after 24 weeks of treatment. Results: There were no significant differences between treatments with respect to eosinophils in the bronchial mucosa and bronchoalveolar lavage fluid; mucosal mast cells, neutrophils, or CD3 +, CD4 +, CD8 +, or CD25 + T lymphocytes; or concentration of mediators (GM-CSF, IL-8, and eosinophil cationic protein). The 2 treatments were not different with respect to lamina reticularis thickness. Consistent with the airway inflammatory measures, clinical and physiologic measures of asthma control were also similar. Conclusion: This study demonstrates that control of asthma and airway inflammation is maintained over the 24-week treatment period when patients requiring a medium-dose ICS are switched to a lower-dose ICS with a LABA. Clinical implications: A lower-dose ICS with a LABA is effective in controlling inflammation and providing clinical asthma control, confirming current guideline recommendations.

KW - Fluticasone propionate

KW - biopsy

KW - bronchoalveolar lavage

KW - eosinophils

KW - salmeterol

UR - http://www.scopus.com/inward/record.url?scp=33745356774&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745356774&partnerID=8YFLogxK

U2 - 10.1016/j.jaci.2006.03.043

DO - 10.1016/j.jaci.2006.03.043

M3 - Article

VL - 118

SP - 44

EP - 52

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

SN - 0091-6749

IS - 1

ER -