[Better control of asthma symptoms with salmeterol]

Patients treated for severe bronchial asthma often suffer from attacks of bronchoconstriction despite appropriate anti-inflammatory treatment. The aim of this study was to find out whether the use of salmeterol (Serevent) in this group of patients might significantly improve the course of asthma. Patients with a stable course of asthma for last 4 weeks prior to the start of study were included. All had been treated with inhaled corticosteroids and some had been on oral corticosteroids as well, but they had also needed either regular treatment with short-acting beta 2-agonists or had taken them "on demand", at least 4 puffs/24 h. One hundred and three patients were included in the study. Their ages ranged from 6 to 60 years (mean, 24 +/- 17.7); the mean duration of asthma was 11.7 +/- 7.7 years and they had been treated with corticosteroids for a mean period of 4.4 +/- 4.8 years. Addition of salmeterol to therapy produced a rapid significant improvement of all parameters investigated, which was gradual and reached its peak at the end of the fourth (last) week of treatment. All the parameters measured, symptom index, PEF and spirometry findings significantly improved in the course of treatment. After discontinuation of treatment, deterioration was observed, although even at two weeks the mean values of the parameters measured were significantly better compared to the pre-treatment findings. The study has demonstrated that a regular treatment with salmeterol in patients with serve bronchial asthma allows very good control of symptoms in most patients while spirometry findings return to normal. The beneficial effect of salmeterol can be observed many days after discontinuation, which might suggest certain anti-inflammatory effects of salmeterol in addition to its bronchorelaxant action.