Combined Salmeterol/Fluticasone Propionate Assessed in Recurrent Wheezing, Asthma

Episodically treating children with recurrent wheezing with inhaled combined salmeterol/fluticasone propionate may be as effective as a daily inhaled fluticasone propionate regimen.

This article is part of MPR‘s coverage of the American Academy of Allergy, Asthma & Immunology, taking place in Orlando, Florida. Our staff will report on medical research related to asthma and other respiratory conditions, conducted by experts in the field. Check back regularly for more news from AAAAI/WAO 2018.

Treating children with recurrent wheezing during each episode with inhaled combined salmeterol/fluticasone propionate (ISFP) may be as effective as a daily inhaled fluticasone propionate (IFP) regimen, according to a study presented at the American Academy of Allergy, Asthma & Immunology/World Allergy Organization annual meeting, held March 2 through 5, 2018, in Orlando, Florida.

This study was conducted by investigators at Queen Sirikit National Institute of Child Health in Bangkok, Thailand. The reduced stringency associated with the ISFP treatment regimen would benefit Thai children with persistent asthma, to whom parents may administer inhaled corticosteroids on an episodic vs daily basis.

In this study, children (n=44; age 1-15 years) with a tendency for asthma and exhibiting recurrent wheezing, were randomly assigned to receive IFP daily or a 14-day regimen of ISFP initiated at onset of symptoms of respiratory tract illness. The percentage of exacerbations requiring systemic corticosteroid administration was the study’s primary outcome, and monthly change in height was the secondary outcome.

Six months after treatment, patients who had received daily IFP had a comparable primary outcome (hazard ratio [HR], 1.224; 95% CI, 0.278-5.392; P =.790). Monthly changes in height were similar with the 2 treatments (0.66 cm with daily IFP vs 0.67 cm with episodic ISFP; P =.869).

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In addition, median cumulative dose of inhaled corticosteroid was higher in children who received daily IFP (45 mg) vs episodic ISFP (5.25 mg; P <.001). No ISFP treatment-related adverse events were reported.

“There were no significant differences in reducing exacerbation and height suppression between daily IFP and episodic ISFP in a 6-month period,” concluded the investigators.

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Chamnanrua J, Daengsuwan T. Comparative efficacy of daily inhaled fluticasone propionate and episodic inhaled combined salmeterol/fluticasone propionate in children with recurrent wheezing. Presented at: AAAAI/WAO Joint Congress; March 2-5, 2018; Orlando, FL. Abstract 650.

This article originally appeared on Pulmonology Advisor