Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2014

Open Access 01-12-2014 | Research article

Extrafine Beclomethasone/formoterol compared to Fluticasone/salmeterol Combination Therapy in COPD

Authors: Dave Singh, Gabriele Nicolini, Eddi Bindi, Massimo Corradi, Daniele Guastalla, Jorg Kampschulte, Władysław Pierzchała, Abdullah Sayiner, Mária Szilasi, Claudio Terzano, Jørgen Vestbo

Published in: BMC Pulmonary Medicine | Issue 1/2014

Login to get access

Abstract

Background

The study evaluated the efficacy of beclomethasone dipropionate/formoterol fumarate (BDP/FF) extrafine combination versus fluticasone propionate/salmeterol (FP/S) combination in COPD patients.

Methods

The trial was a 12-week multicentre, randomised, double-blind, double dummy study; 419 patients with moderate/severe COPD were randomised to BDP/FF 200/12 μg or FP/S 500/50 μg twice daily. The primary objective was to demonstrate the equivalence between treatments in terms of Transition Dyspnoea Index (TDI) score and the superiority of BDP/FF in terms of change from pre-dose in the first 30 minutes in forced expiratory volume in the first second (FEV1). Secondary endpoints included lung function, symptom scores, symptom-free days and use of rescue medication, St. George’s Respiratory Questionnaire, six minute walking test and COPD exacerbations.

Results

BDP/FF was equivalent to FP/S in terms of TDI score and superior in terms of FEV1 change from pre-dose (p < 0.001). There were no significant differences between treatments in secondary outcome measures, confirming overall comparability in terms of efficacy and tolerability. Moreover, a clinically relevant improvement (>4 units) in SGRQ was detected in the BDP/FF group only.

Conclusion

BDP/FF extrafine combination provides COPD patients with an equivalent improvement of dyspnoea and a faster bronchodilation in comparison to FP/S.

Trial registration

ClinicalTrials.gov: NCT01245569
Appendix
Available only for authorised users
Literature
1.
go back to reference Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, Barnes PJ, Fabbri LM, Martinez FJ, Nishimura M, Stockley RA, Sin DD, Rodriguez-Roisin R: Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease, GOLD Executive Summary. Am J Respir Crit Care Med. 2013, 187 (4): 347-365. 10.1164/rccm.201204-0596PP. 10.1164/rccm.201204-0596PPCrossRefPubMed Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, Barnes PJ, Fabbri LM, Martinez FJ, Nishimura M, Stockley RA, Sin DD, Rodriguez-Roisin R: Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease, GOLD Executive Summary. Am J Respir Crit Care Med. 2013, 187 (4): 347-365. 10.1164/rccm.201204-0596PP. 10.1164/rccm.201204-0596PPCrossRefPubMed
2.
go back to reference Kessler R, Partridge MR, Miravitlles M, Cazzola M, Vogelmeier C, Leynaud D, Ostinelli J: Symptom variability in patients with severe COPD: a pan-European cross-sectional study. Eur Respir J. 2011, 37 (2): 264-272. 10.1183/09031936.00051110.CrossRefPubMed Kessler R, Partridge MR, Miravitlles M, Cazzola M, Vogelmeier C, Leynaud D, Ostinelli J: Symptom variability in patients with severe COPD: a pan-European cross-sectional study. Eur Respir J. 2011, 37 (2): 264-272. 10.1183/09031936.00051110.CrossRefPubMed
3.
go back to reference Dong YH, Lin HH, Shau WY, Wu YC, Chang CH, Lai MS: Comparative safety of inhaled medications in patients with chronic obstructive pulmonary disease: systematic review and mixed treatment comparison meta-analysis of randomized controlled trials. Thorax. 2013, 68 (1): 48-56. 10.1136/thoraxjnl-2012-201926.CrossRefPubMed Dong YH, Lin HH, Shau WY, Wu YC, Chang CH, Lai MS: Comparative safety of inhaled medications in patients with chronic obstructive pulmonary disease: systematic review and mixed treatment comparison meta-analysis of randomized controlled trials. Thorax. 2013, 68 (1): 48-56. 10.1136/thoraxjnl-2012-201926.CrossRefPubMed
4.
go back to reference Barnes PJ: Scientific rationale for inhaled combination therapy with long-acting beta2-agonists and corticosteroids. Eur Respir J. 2002, 19: 182-191. 10.1183/09031936.02.00283202.CrossRefPubMed Barnes PJ: Scientific rationale for inhaled combination therapy with long-acting beta2-agonists and corticosteroids. Eur Respir J. 2002, 19: 182-191. 10.1183/09031936.02.00283202.CrossRefPubMed
5.
go back to reference Caramori G, Ito K, Papi A, Adcock IM: Interactions between long-acting β2 agonists and glucocorticoids. Drug Discov Today Ther Strateg. 2006, 3: 261-268.CrossRef Caramori G, Ito K, Papi A, Adcock IM: Interactions between long-acting β2 agonists and glucocorticoids. Drug Discov Today Ther Strateg. 2006, 3: 261-268.CrossRef
6.
go back to reference Drummond MB, Dasenbrook EC, Pitz MW, Murphy DJ, Fan E: Inhaled corticosteroids in patients with stable chronic obstructive pulmonary disease: a systematic review and meta-analysis. JAMA. 2008, 300 (20): 2407-2416. 10.1001/jama.2008.717.CrossRefPubMedPubMedCentral Drummond MB, Dasenbrook EC, Pitz MW, Murphy DJ, Fan E: Inhaled corticosteroids in patients with stable chronic obstructive pulmonary disease: a systematic review and meta-analysis. JAMA. 2008, 300 (20): 2407-2416. 10.1001/jama.2008.717.CrossRefPubMedPubMedCentral
7.
go back to reference Singh S, Amin AV, Loke YK: Long-term use of inhaled corticosteroids and the risk of pneumonia in chronic obstructive pulmonary disease: a meta-analysis. Arch Intern Med. 2009, 169: 219-229. 10.1001/archinternmed.2008.550.CrossRefPubMed Singh S, Amin AV, Loke YK: Long-term use of inhaled corticosteroids and the risk of pneumonia in chronic obstructive pulmonary disease: a meta-analysis. Arch Intern Med. 2009, 169: 219-229. 10.1001/archinternmed.2008.550.CrossRefPubMed
8.
go back to reference Singh S, Loke YK: Risk of pneumonia associated with long-term use of inhaled corticosteroids in chronic obstructive pulmonary disease: a critical review and update. Curr Opin Pulm Med. 2010, 16: 118-122. 10.1097/MCP.0b013e328334c085.CrossRefPubMedPubMedCentral Singh S, Loke YK: Risk of pneumonia associated with long-term use of inhaled corticosteroids in chronic obstructive pulmonary disease: a critical review and update. Curr Opin Pulm Med. 2010, 16: 118-122. 10.1097/MCP.0b013e328334c085.CrossRefPubMedPubMedCentral
9.
go back to reference Nannini LJ, Lasserson TJ, Poole P: Combined corticosteroid and long-acting beta(2) agonist in one inhaler versus long-acting beta(2)-agonists for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2012, 12 (9): CD006829- Nannini LJ, Lasserson TJ, Poole P: Combined corticosteroid and long-acting beta(2) agonist in one inhaler versus long-acting beta(2)-agonists for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2012, 12 (9): CD006829-
10.
go back to reference Singh D, Kampschulte J, Wedzicha JA, Jones PW, Cohuet G, Corradi M, Higenbottam T, Petruzzelli S, Vestbo J: A trial of beclomethasone/formoterol in COPD using EXACT-PRO to measure exacerbations. Eur Respir J. 2013, 41 (1): 12-17. 10.1183/09031936.00207611.CrossRefPubMed Singh D, Kampschulte J, Wedzicha JA, Jones PW, Cohuet G, Corradi M, Higenbottam T, Petruzzelli S, Vestbo J: A trial of beclomethasone/formoterol in COPD using EXACT-PRO to measure exacerbations. Eur Respir J. 2013, 41 (1): 12-17. 10.1183/09031936.00207611.CrossRefPubMed
11.
go back to reference Calverley PM, Kuna P, Monsó E, Costantini M, Petruzzelli S, Sergio F, Varoli G, Papi A, Brusasco V: Beclomethasone/formoterol in the management of COPD: a randomised controlled trial. Respir Med. 2010, 104: 1858-1868. 10.1016/j.rmed.2010.09.008.CrossRefPubMed Calverley PM, Kuna P, Monsó E, Costantini M, Petruzzelli S, Sergio F, Varoli G, Papi A, Brusasco V: Beclomethasone/formoterol in the management of COPD: a randomised controlled trial. Respir Med. 2010, 104: 1858-1868. 10.1016/j.rmed.2010.09.008.CrossRefPubMed
12.
go back to reference Cazzola M, Paggiaro P, Palange P, Bjermer L, Ausin P, Carlsson LG, Ekelund J, Lotvall J: Onset of action of formoterol versus salmeterol via dry powder inhalers in moderate chronic obstructive pulmonary disease: a randomized, placebo-controlled, double-blind, crossover study. Clin Drug Investig. 2012, 32 (3): 147-155. 10.2165/11630880-000000000-00000.CrossRefPubMed Cazzola M, Paggiaro P, Palange P, Bjermer L, Ausin P, Carlsson LG, Ekelund J, Lotvall J: Onset of action of formoterol versus salmeterol via dry powder inhalers in moderate chronic obstructive pulmonary disease: a randomized, placebo-controlled, double-blind, crossover study. Clin Drug Investig. 2012, 32 (3): 147-155. 10.2165/11630880-000000000-00000.CrossRefPubMed
13.
go back to reference Lindberg A, Szalai Z, Pullerits T, Radeczky E: Fast onset of effect of budesonide/formoterol versus salmeterol/fluticasone and salbutamol in patients with chronic obstructive pulmonary disease and reversible airway obstruction. Respirology. 2007, 12: 732-739. 10.1111/j.1440-1843.2007.01132.x.CrossRefPubMed Lindberg A, Szalai Z, Pullerits T, Radeczky E: Fast onset of effect of budesonide/formoterol versus salmeterol/fluticasone and salbutamol in patients with chronic obstructive pulmonary disease and reversible airway obstruction. Respirology. 2007, 12: 732-739. 10.1111/j.1440-1843.2007.01132.x.CrossRefPubMed
14.
go back to reference Partridge MR, Schuermann W, Beckman O, Persson T, Polanowski T: Effect on lung function and morning activities of budesonide/formoterol versus salmeterol/fluticasone in patients with COPD. Ther Adv Respir Dis. 2009, 3 (4): 1-11.CrossRefPubMed Partridge MR, Schuermann W, Beckman O, Persson T, Polanowski T: Effect on lung function and morning activities of budesonide/formoterol versus salmeterol/fluticasone in patients with COPD. Ther Adv Respir Dis. 2009, 3 (4): 1-11.CrossRefPubMed
15.
go back to reference Mahler DA, Weinberg DH, Wells CK, Feinstein AR: The measurement of dyspnea. Contents, interobserver agreement, and physiologic correlates of two new clinical indexes. Chest. 1984, 85: 751-758. 10.1378/chest.85.6.751.CrossRefPubMed Mahler DA, Weinberg DH, Wells CK, Feinstein AR: The measurement of dyspnea. Contents, interobserver agreement, and physiologic correlates of two new clinical indexes. Chest. 1984, 85: 751-758. 10.1378/chest.85.6.751.CrossRefPubMed
16.
go back to reference Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J: ATS/ERS Task Force. Standardisation of spirometry. Eur Respir J. 2005, 2: 319-338.CrossRef Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J: ATS/ERS Task Force. Standardisation of spirometry. Eur Respir J. 2005, 2: 319-338.CrossRef
17.
go back to reference Jones PW, Quirk FH, Baveystock CM, Littlejohns P: A self-complete measure for chronic airflow limitation - the St George’s Respiratory Questionnaire. Am Rev Respir Dis. 1992, 145: 1321-1327. 10.1164/ajrccm/145.6.1321.CrossRefPubMed Jones PW, Quirk FH, Baveystock CM, Littlejohns P: A self-complete measure for chronic airflow limitation - the St George’s Respiratory Questionnaire. Am Rev Respir Dis. 1992, 145: 1321-1327. 10.1164/ajrccm/145.6.1321.CrossRefPubMed
18.
go back to reference Schünemann HJ, Griffith L, Jaeschke R, Goldstein R, Stubbing D, Guyatt GH: Evaluation of the minimal important difference for the feeling thermometer and the St George’s Respiratory Questionnaire in patients with chronic airflow obstruction. J Clin Epidemiol. 2003, 56: 1170-1176. 10.1016/S0895-4356(03)00115-X.CrossRefPubMed Schünemann HJ, Griffith L, Jaeschke R, Goldstein R, Stubbing D, Guyatt GH: Evaluation of the minimal important difference for the feeling thermometer and the St George’s Respiratory Questionnaire in patients with chronic airflow obstruction. J Clin Epidemiol. 2003, 56: 1170-1176. 10.1016/S0895-4356(03)00115-X.CrossRefPubMed
19.
go back to reference Statement ATS: Guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002, 166: 111-117.CrossRef Statement ATS: Guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002, 166: 111-117.CrossRef
20.
go back to reference Calverley PM, Anderson JA, Celli B, Ferguson GT, Jenkins C, Jones PW, Yates JC, Vestbo J: TORCH investigators. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med. 2007, 356: 775-789. 10.1056/NEJMoa063070.CrossRefPubMed Calverley PM, Anderson JA, Celli B, Ferguson GT, Jenkins C, Jones PW, Yates JC, Vestbo J: TORCH investigators. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med. 2007, 356: 775-789. 10.1056/NEJMoa063070.CrossRefPubMed
21.
go back to reference Witek TJ, Mahler DA: Meaningful effect size and patterns of response of the transition dyspnea index. J Clin Epidemiol. 2003, 56: 248-255. 10.1016/S0895-4356(02)00589-9.CrossRefPubMed Witek TJ, Mahler DA: Meaningful effect size and patterns of response of the transition dyspnea index. J Clin Epidemiol. 2003, 56: 248-255. 10.1016/S0895-4356(02)00589-9.CrossRefPubMed
22.
go back to reference Witek TJ, Mahler DA: Minimal important difference of the transition dyspnoea index in a multinational clinical trial. Eur Respir J. 2003, 21: 267-272. 10.1183/09031936.03.00068503a.CrossRefPubMed Witek TJ, Mahler DA: Minimal important difference of the transition dyspnoea index in a multinational clinical trial. Eur Respir J. 2003, 21: 267-272. 10.1183/09031936.03.00068503a.CrossRefPubMed
23.
go back to reference Partridge MR, Karlsson N, Small IR: Patient insight into the impact of chronic obstructive pulmonary disease in the morning: an internet survey. Curr Med Res Opin. 2009, 25 (8): 2043-2048. 10.1185/03007990903103006.CrossRefPubMed Partridge MR, Karlsson N, Small IR: Patient insight into the impact of chronic obstructive pulmonary disease in the morning: an internet survey. Curr Med Res Opin. 2009, 25 (8): 2043-2048. 10.1185/03007990903103006.CrossRefPubMed
24.
go back to reference Van Noord JA, Smeets JJ, Raaijmakers JA, Bommer AM, Maesen FP: Salmeterol versus formoterol in patients with moderately severe asthma: onset and duration of action. Eur Respir J. 1996, 9 (8): 1684-1688. 10.1183/09031936.96.09081684.CrossRefPubMed Van Noord JA, Smeets JJ, Raaijmakers JA, Bommer AM, Maesen FP: Salmeterol versus formoterol in patients with moderately severe asthma: onset and duration of action. Eur Respir J. 1996, 9 (8): 1684-1688. 10.1183/09031936.96.09081684.CrossRefPubMed
25.
go back to reference Kottakis J, Cioppa GD, Creemers J, Greefhorst L, Lecler V, Pistelli R, Overend T, Till D, Rapatz G, Le Gros V, Bouros D, Siafakas N: Faster onset of bronchodilation with formoterol than with salmeterol in patients with stable, moderate to severe COPD: results of a randomized, double-blind clinical study. Can Respir J. 2002, 9 (2): 107-115.CrossRefPubMed Kottakis J, Cioppa GD, Creemers J, Greefhorst L, Lecler V, Pistelli R, Overend T, Till D, Rapatz G, Le Gros V, Bouros D, Siafakas N: Faster onset of bronchodilation with formoterol than with salmeterol in patients with stable, moderate to severe COPD: results of a randomized, double-blind clinical study. Can Respir J. 2002, 9 (2): 107-115.CrossRefPubMed
26.
go back to reference Bouros D, Kottakis J, Le Gros V, Overend T, Della Cioppa G, Siafakas N: Effects of formoterol and salmeterol on resting inspiratory capacity in COPD patients with poor FEV(1) reversibility. Curr Med Res Opin. 2004, 20 (5): 581-586. 10.1185/030079904125003368.CrossRefPubMed Bouros D, Kottakis J, Le Gros V, Overend T, Della Cioppa G, Siafakas N: Effects of formoterol and salmeterol on resting inspiratory capacity in COPD patients with poor FEV(1) reversibility. Curr Med Res Opin. 2004, 20 (5): 581-586. 10.1185/030079904125003368.CrossRefPubMed
27.
go back to reference Cazzola M, Santus P, Di Marco F, Boveri B, Castagna F, Carlucci P, Matera MG, Centanni S: Bronchodilator effect of an inhaled combination therapy with salmeterol + fluticasone and formoterol + budesonide in patients with COPD. Respir Med. 2003, 97 (5): 453-457. 10.1053/rmed.2002.1455.CrossRefPubMed Cazzola M, Santus P, Di Marco F, Boveri B, Castagna F, Carlucci P, Matera MG, Centanni S: Bronchodilator effect of an inhaled combination therapy with salmeterol + fluticasone and formoterol + budesonide in patients with COPD. Respir Med. 2003, 97 (5): 453-457. 10.1053/rmed.2002.1455.CrossRefPubMed
28.
go back to reference Celik G, Kayacan O, Beder S, Durmaz G: Formoterol and salmeterol in partially reversible chronic obstructive pulmonary disease: a crossover, placebo-controlled comparison of onset and duration of action. Respiration. 1999, 66 (5): 434-439. 10.1159/000029427.CrossRefPubMed Celik G, Kayacan O, Beder S, Durmaz G: Formoterol and salmeterol in partially reversible chronic obstructive pulmonary disease: a crossover, placebo-controlled comparison of onset and duration of action. Respiration. 1999, 66 (5): 434-439. 10.1159/000029427.CrossRefPubMed
30.
go back to reference Cazzola M, Page CP, Rogliani P, Matera MG: β2-agonist therapy in lung disease. Am J Respir Crit Care Med. 2013, 187 (7): 690-696. 10.1164/rccm.201209-1739PP.CrossRefPubMed Cazzola M, Page CP, Rogliani P, Matera MG: β2-agonist therapy in lung disease. Am J Respir Crit Care Med. 2013, 187 (7): 690-696. 10.1164/rccm.201209-1739PP.CrossRefPubMed
31.
go back to reference Nicolini G, Scichilone N, Bizzi A, Papi A, Fabbri LM: Beclomethasone/formoterol fixed combination for the management of asthma: patient considerations. Ther Clin Risk Manag. 2008, 4: 855-864.PubMedPubMedCentral Nicolini G, Scichilone N, Bizzi A, Papi A, Fabbri LM: Beclomethasone/formoterol fixed combination for the management of asthma: patient considerations. Ther Clin Risk Manag. 2008, 4: 855-864.PubMedPubMedCentral
32.
go back to reference Scichilone N, Battaglia S, Sorino C, Paglino G, Martino L, Paternò A, Santagata R, Spatafora M, Nicolini G, Bellia V: Effects of extra-fine inhaled beclomethasone/formoterol on both large and small airways in asthma. Allergy. 2010, 65: 897-902. 10.1111/j.1398-9995.2009.02306.x.CrossRefPubMed Scichilone N, Battaglia S, Sorino C, Paglino G, Martino L, Paternò A, Santagata R, Spatafora M, Nicolini G, Bellia V: Effects of extra-fine inhaled beclomethasone/formoterol on both large and small airways in asthma. Allergy. 2010, 65: 897-902. 10.1111/j.1398-9995.2009.02306.x.CrossRefPubMed
33.
go back to reference Papi A, Paggiaro PL, Nicolini G, Vignola AM, Fabbri LM: Beclomethasone/formoterol versus budesonide/formoterol combination therapy in asthma. Eur Respir J. 2007, 29: 682-689. 10.1183/09031936.00095906.CrossRefPubMed Papi A, Paggiaro PL, Nicolini G, Vignola AM, Fabbri LM: Beclomethasone/formoterol versus budesonide/formoterol combination therapy in asthma. Eur Respir J. 2007, 29: 682-689. 10.1183/09031936.00095906.CrossRefPubMed
34.
go back to reference Huchon G, Magnussen H, Chuchalin A, Dymek L, Gonod FB, Bousquet J: Lung function and asthma control with beclomethasone and formoterol in a single inhaler. Respir Med. 2009, 103: 41-49. 10.1016/j.rmed.2008.09.002.CrossRefPubMed Huchon G, Magnussen H, Chuchalin A, Dymek L, Gonod FB, Bousquet J: Lung function and asthma control with beclomethasone and formoterol in a single inhaler. Respir Med. 2009, 103: 41-49. 10.1016/j.rmed.2008.09.002.CrossRefPubMed
35.
go back to reference Hogg JC, Chu F, Utokaparch S, Woods R, Elliott WM, Buzatu L, Cherniack RM, Rogers RM, Sciurba FC, Coxson HO, Paré PD: The nature of small-airway obstruction in chronic obstructive pulmonary disease. N Engl J Med. 2004, 350 (26): 2645-2653. 10.1056/NEJMoa032158.CrossRefPubMed Hogg JC, Chu F, Utokaparch S, Woods R, Elliott WM, Buzatu L, Cherniack RM, Rogers RM, Sciurba FC, Coxson HO, Paré PD: The nature of small-airway obstruction in chronic obstructive pulmonary disease. N Engl J Med. 2004, 350 (26): 2645-2653. 10.1056/NEJMoa032158.CrossRefPubMed
36.
go back to reference Tzani P, Crisafulli E, Nicolini G, Aiello M, Chetta A, Clini EM, Olivieri D: Effects of beclomethasone/formoterol fixed combination on lung hyperinflation and dyspnea in COPD patients. Int J Chron Obstruct Pulmon Dis. 2011, 6: 503-509.PubMedPubMedCentral Tzani P, Crisafulli E, Nicolini G, Aiello M, Chetta A, Clini EM, Olivieri D: Effects of beclomethasone/formoterol fixed combination on lung hyperinflation and dyspnea in COPD patients. Int J Chron Obstruct Pulmon Dis. 2011, 6: 503-509.PubMedPubMedCentral
38.
go back to reference Hanania NA, Darken P, Horstman D, Reisner C, Lee B, Davis S, Shah T: The efficacy and safety of fluticasone propionate (250 μg)/salmeterol (50 μg) combined in the Diskus inhaler for the treatment of COPD. Chest. 2003, 124: 834-843. 10.1378/chest.124.3.834.CrossRefPubMed Hanania NA, Darken P, Horstman D, Reisner C, Lee B, Davis S, Shah T: The efficacy and safety of fluticasone propionate (250 μg)/salmeterol (50 μg) combined in the Diskus inhaler for the treatment of COPD. Chest. 2003, 124: 834-843. 10.1378/chest.124.3.834.CrossRefPubMed
39.
go back to reference Ferguson GT, Anzueto A, Fei R, Emmett A, Knobil K, Kalberg C: Effect of fluticasone propionate/salmeterol (250/50 microg) or salmeterol (50 microg) on COPD exacerbations. Respir Med. 2008, 102 (8): 1099-1108. 10.1016/j.rmed.2008.04.019.CrossRefPubMed Ferguson GT, Anzueto A, Fei R, Emmett A, Knobil K, Kalberg C: Effect of fluticasone propionate/salmeterol (250/50 microg) or salmeterol (50 microg) on COPD exacerbations. Respir Med. 2008, 102 (8): 1099-1108. 10.1016/j.rmed.2008.04.019.CrossRefPubMed
40.
go back to reference Anzueto A, Ferguson GT, Feldman G, Chinsky K, Seibert A, Emmett A, Knobil K, O'Dell D, Kalberg C, Crater G: Effect of fluticasone propionate/salmeterol (250/50) on COPD exacerbations and impact on patient outcomes. COPD. 2009, 6 (5): 320-329. 10.1080/15412550903140881.CrossRefPubMed Anzueto A, Ferguson GT, Feldman G, Chinsky K, Seibert A, Emmett A, Knobil K, O'Dell D, Kalberg C, Crater G: Effect of fluticasone propionate/salmeterol (250/50) on COPD exacerbations and impact on patient outcomes. COPD. 2009, 6 (5): 320-329. 10.1080/15412550903140881.CrossRefPubMed
Metadata
Title
Extrafine Beclomethasone/formoterol compared to Fluticasone/salmeterol Combination Therapy in COPD
Authors
Dave Singh
Gabriele Nicolini
Eddi Bindi
Massimo Corradi
Daniele Guastalla
Jorg Kampschulte
Władysław Pierzchała
Abdullah Sayiner
Mária Szilasi
Claudio Terzano
Jørgen Vestbo
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2014
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/1471-2466-14-43

Other articles of this Issue 1/2014

BMC Pulmonary Medicine 1/2014 Go to the issue