The Efficacy of Combination of Inhalation Salmeterol and Fluticasone Compare with Budesonide Inhalation to Control Moderate Persistent Asthma by The Use of Asthma Control Test as Evaluation Tool

· Asthma

Tabri NA, Supriyadi M, Yunus F, Wiyono WH. J Respir Indones. 2010;30(3):152-8.

Study objective: To investigate wheter combination of steroid (fluticasone) and long acting ß2 agonist (salmeterol) inhalation better than budesonide inhalation to control moderate persistent asthma by evaluation with Asthma Control Test and FEV1 Design: Clinical trial with randomized pretest-posttest comparative group design
Setting: Moderate persistent asthma due to the GINA 2005 criteria who came to Asthma Clinics Persahabatan Hospital divided to 2 groups. Group 1 treated with budesonide inhalation for 3 month and group 2 treated with salmeterol/fluticasone inhalation for 2 month and 1 month wash-out. The study started from March 2007 until February 2008.
Subjects: Moderate persistent asthma patients man or woman with the age 12-65 years old, could perform lung function test and laboratory examination in normal limit.
Results: Thirty eight subjects of budesonide group with mean FEV1 and previous ACT score 62,21% and 13,89 at end of the first, second and third month after that there was increased of FEV1 66,52%, 65,12% and 63,60% respectively with the statitistical analysis not significant (p > 0,05) while the increased of ACT scores were 17,42, 17,74 and 17,16 with the statistical analysis was significant (p < 0,05) but the ACT scores not achieves the value of controlled ACT scores 19. Thirty three of salmeterol/fluticasone group had the previous mean of FEV1 and ACT scores 60,43% and 12,24 at the end of the first and second month there was an increased of FEV1 68,13% dan 71,10% respectively with the statistical analysis was significant (p < 0,05). When wash out (end of third month) there was the decreased of FEV1 66,35% while the ACT scores were 19,27 and 21,18 respectively with the statistical analysis was significant (p < 0,05). There was decrease of ACT scores 17,27 when wash out. The percentage of controlled asthma at the end of second month in budesonide group was 36,8% and salmeterol/fluticasone group was 81,8% with the statistical analysis was significant (p=0,05).
Conclusions: Fluticasone/salmeterol group was better in controlled asthma with the better FEV1 compared with budesonide group.

Keywords: Moderate persistent asthma, ACT, FEV1, fluticasone/salmeterol, budesonide

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