Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine (May 2018)

Low-dose Fluticasone Propionate in Combination With Salmeterol in Patients With Chronic Obstructive Pulmonary Disease

  • Hideki Yasui,
  • Naoki Inui,
  • Tomoyuki Fujisawa,
  • Masato Karayama,
  • Noriyuki Enomoto,
  • Yutaro Nakamura,
  • Shigeki Kuroishi,
  • Hisano Ohba,
  • Koshi Yokomura,
  • Jun Sato,
  • Masaki Sato,
  • Naoki Koshimizu,
  • Mikio Toyoshima,
  • Takashi Yamada,
  • Masafumi Masuda,
  • Toshihiro Shirai,
  • Takafumi Suda

DOI
https://doi.org/10.1177/1179548418771702
Journal volume & issue
Vol. 12

Abstract

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Inhaled corticosteroids are widely used in the treatment of chronic obstructive pulmonary disease (COPD). However, their use has been questioned for appropriate dose and a possible increased risk of pneumonia. Here, we reviewed patients with COPD who had received fluticasone–salmeterol combination treatment using data from a linked electronic medical record database. A total of 180 patients received salmeterol with 250 µg fluticasone propionate twice daily and 78 received salmeterol and 100 µg fluticasone propionate twice daily. In both groups, there was no difference in the improved forced expiratory volume in 1 second and COPD assessment test score and the proportion of patients with exacerbations. Although the incidence of common toxicity was approximately equal, that of pneumonia was much higher in the 250 µg group (8.9% vs 1.3%, P =.01). The beneficial effects of inhaled corticosteroids might be obtained at lower doses.