Related Experiment Video
Updated: Jun 27, 2026
14:39
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Asthma control over 3 years in a real-life study.
Bo Lundbäck1, Eva Rönmark, Anne Lindberg
1Department of Internal Medicine/Respiratory Medicine and Allergology, Sahlgrenska Academy, University of Göteborg, Sweden. bo.lundback@gu.se
Respiratory Medicine
|December 2, 2008
Summary
This 3-year study found that combination therapy with salmeterol/fluticasone (SFC) was more effective for long-term asthma control than salmeterol (SAL) or fluticasone (FP) alone. Patients on SFC required less frequent medication increases, demonstrating superior asthma management.
Area of Science:
- Pulmonology
- Pharmacology
- Clinical Medicine
Background:
- Asthma control remains a challenge, necessitating flexible treatment strategies.
- Physician-driven adjustments in medication are crucial for maintaining long-term asthma control.
- Comparative effectiveness of different inhaled corticosteroid/long-acting beta-agonist combinations requires further real-world investigation.
Purpose of the Study:
- To compare the effectiveness of salmeterol/fluticasone (SFC), fluticasone propionate (FP), and salmeterol (SAL) in achieving and maintaining asthma control over three years.
- To evaluate the need for medication increases in patients treated with different inhaler combinations.
- To assess the impact of treatment on symptoms, lung function, and airway hyperresponsiveness.
Main Methods:
- A 3-year, randomized, real-life study involving 282 asthma patients.
- Patients received salmeterol/fluticasone (SFC) 50/250mcg, fluticasone propionate (FP) 250mcg, or salmeterol (SAL) 50mcg via Diskus inhaler, twice daily.
- A 12-month double-blind phase was followed by a 2-year open-label phase with physician-guided medication adjustments.
Main Results:
- At study completion, 73% of patients on SFC maintained asthma control, compared to 21% on FP and 5% on SAL.
- Patients initially randomized to FP and SAL required significantly more frequent medication increases (OR 2.66 and 9.38, respectively) than those on SFC.
- Time to first medication increase was longest for SFC (21 months) versus FP (12 months) and SAL (6 months).
- Improvements in symptoms, rescue medication use, PEF, and airway hyperresponsiveness were observed, with greatest gains in the first year.
Conclusions:
- The majority of asthma patients can achieve and maintain control over three years with physician-guided medication adjustments.
- Salmeterol/fluticasone combination therapy is more effective in achieving and maintaining asthma control compared to fluticasone propionate or salmeterol alone.
- Sustained improvement in airway hyperresponsiveness highlights the importance of continuous treatment even after clinical control is achieved.
Related Concept Videos
01:24Asthma-III: Symptoms and Complications
Asthma, a common chronic respiratory condition, is classified considering the frequency and severity of symptoms alongside lung function impairment. Understanding this classification is essential for appropriate treatment and management. Here's a detailed look at the classification of asthma and its clinical features and complications:
Classification of Asthma
Classification of Asthma
01:13Asthma III: Clinical Manifestations
Asthma presents with a characteristic pattern of episodic respiratory symptoms that reflect underlying airway inflammation, bronchoconstriction, and mucus hypersecretion. Although severity varies among individuals, certain clinical manifestations are considered hallmarks of the disorder and often guide diagnosis and assessment.Respiratory SymptomsA persistent cough is one of the most common early features of asthma. It is frequently dry and tends to worsen at night or in the early morning,...
01:30Asthma-IV: Nursing Management
The nursing management of asthma is a comprehensive approach that relies heavily on the expertise and dedication of healthcare professionals. It involves thorough assessment, accurate diagnosis, strategic planning, effective implementation, and diligent evaluation. By meticulously following this step-by-step process, healthcare professionals play a crucial role in providing the best possible care and treatment for patients with asthma, enhancing their overall health and well-being.
First, in...
First, in...
01:29Asthma-I: Introduction
Asthma is a chronic respiratory ailment that requires careful management due to its varying symptoms and influencing factors. It is characterized by airway inflammation, bronchial hyperresponsiveness, and reversible airflow obstruction, leading to symptoms like wheezing, shortness of breath, chest tightness, and coughing. The symptom frequency and intensity may vary considerably over time. It is also linked to immune system responses to allergens and irritants, highlighting the complex...
01:30Asthma-IV: Diagnostic and Management
The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:28Asthma I: Introduction
Asthma is a chronic inflammatory disorder of the airways characterized by variable airflow obstruction and heightened bronchial responsiveness to a wide range of triggers. The underlying inflammation leads to airway swelling, mucus hypersecretion, and smooth muscle constriction, all of which narrow the airway lumen and impede airflow. Clinically, asthma presents with recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing, symptoms that typically vary in intensity and...