24707
document
Minimal tolerance to the bronchoprotective effect of inhaled salmeterol/fluticasone combination on allergene challenge . In order to assess whether the administration of salmeterol/fluticasone propionate combination ( 50/250 mcg by Diskus ) for 1 week induces tolerance to the bronchoprotective effect of salmeterol on allergen challenge , a single-blind , cross-over study was carried out . We studied nine subjects ( eight men and one woman ; mean age+/-SD : 31.3+/-11.0 yr ) with mild intermittent allergic asthma , never treated with regular beta2-agonists or inhaled corticosteroids . In a previous allergen challenge all subjects had shown a positive early airway response ( EAR ) to allergen . They underwent allergen challenge after 1-week treatment with placebo and a single dose of placebo immediately before allergen challenge ( T1 ) , or 1-week treatment with placebo and a single dose of salmeterol/fluticasone immediately before allergen challenge ( T2 ) , or 1-week treatment with salmeterol/fluticasone combination bid and a single dose of salmeterol/fluticasone immediately before allergen challenge ( T3 ) . EAR was evaluated both as maximum decrease in FEV1 ( MaxDeltaFEV1 % ) after allergen challenge and as area under FEV1 -time curve . MaxDeltaFEV1 % during allergen challenge protected by placebo ( T1 ) was significantly greater than MaxDeltaFEV1 % during allergen challenges protected by single dose of salmeterol/fluticasone ( T2 ) and by salmeterol/fluticasone 1-week treatment ( T3 ) . No difference was found in MaxDeltaFEV1 % between T2 and T3 . The same results were observed also after computing the area under the curve for each challenge . When individually considered , all subjects were protected against EAR ( protection index > or = 80 % ) at T2 , while at 3 seven out of nine subjects were still protected against EAR . In conclusion , the simultaneous administration of salmeterol and fluticasone in the same device prevents in almost 80 % of examined subjects the development of tolerance to the protective effect of salmeterol on allergen challenge . This observation may contribute to explain the positive interaction between inhaled beta2-agonists and corticosteroids in the long-term treatment of asthma .
24708
Intervention_Pharmacological
salmeterol/fluticasone
24709
Intervention_Pharmacological
salmeterol/fluticasone propionate
24710
Intervention_Pharmacological
salmeterol
24711
Intervention_Control
placebo
24712
Intervention_Control
placebo
24713
Intervention_Pharmacological
allergen challenge ( T1 )
24714
Intervention_Control
placebo
24715
Intervention_Pharmacological
single dose of salmeterol/fluticasone
24716
Intervention_Pharmacological
allergen challenge ( T2 )
24717
Intervention_Pharmacological
salmeterol/fluticasone
24718
Intervention_Pharmacological
allergen challenge ( T3 )
24719
Outcome_Physical
bronchoprotective effect
24720
Outcome_Other
tolerance
24721
Outcome_Physical
bronchoprotective
24722
Outcome_Physical
early airway response ( EAR )
24723
Outcome_Physical
EAR
24724
Outcome_Physical
FEV1
24725
Outcome_Physical
area under FEV1 -time curve . MaxDeltaFEV1 % during allergen challenge
24726
Outcome_Other
significantly greater
24727
Outcome_Physical
MaxDeltaFEV1 %
24728
Outcome_Other
No difference
24729
Outcome_Physical
MaxDeltaFEV1 %
24730
Outcome_Physical
area under the curve
24731
Outcome_Physical
protected against EAR
24732
Outcome_Physical
protected against EAR .
24733
Outcome_Physical
tolerance to the protective effect