Salmeterol xinafoate as maintenance therapy compared with albuterol in patients with asthma

Salmeterol xinafoate appears to be more effective than albuterol as maintenance therapy for asthma. Salmeterol is a long-acting inhalant designed to inhibit asthma symptoms. Albuterol is a short-acting inhalant designed for the same purpose. A total of 322 asthmatics were randomly assigned to treatment with either two daily doses of salmeterol, four daily doses of albuterol or four daily doses of placebo. All patients used albuterol as needed to control breakthrough asthma symptoms. Those taking salmeterol twice daily for 12 weeks experienced more consistent ease of breathing between doses than those taking albuterol four times daily. Those taking salmeterol also experienced fewer nighttime breathing complications and no statistically significant change in heart rate. Furthermore, the effectiveness of salmeterol was the same at week 12 as it was in the beginning of treatment. The prevalence of adverse side effects such as palpitations, headaches and other body pains were similar for both salmeterol and albuterol.
Objective.--To compare the efficacy and safety of inhaled salmeterol xinafoate, a long-acting [[beta].sub.2]-adrenoceptor agonist, with that of albuterol, a short-acting inhaled [[beta].sub.2]-agonist, in the treatment of asthma. Design.--Randomized, double-blind, placebo-controlled, parallel-group study. Setting.--Eleven outpatient clinical centers. Subjects.--A total of 322 male and female patients at least 12 years of age with chronic symptomatic asthma requiring daily therapy. Intervention.--Patients were treated with salmeterol xinafoate (42 [mu]g inhaled twice daily), albuterol (180 [mu]g inhaled four times daily), or placebo (four times a day) for 12 weeks; patients in all three groups could use inhaled albuterol as backup medication for breakthrough symptoms. Main Outcome Measures.--Serial 12-hour forced expiratory flow in 1 second ([FEV.sub.1]), peak expiratory flow (PEF), asthma symptoms, nocturnal awakenings due to asthma, episodes of asthma exacerbations, and electrocardiography. Results.--The mean area under the curve for [FEV.sub.1] throughout each 12-hour period was consistently greater after a single dose of salmeterol than after two doses of albuterol administered 6 hours apart (P