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Acute protection against exercise-induced bronchoconstriction by formoterol, salmeterol and terbutaline

Pulmonary Research Institute, Hospital Großhansdorf, Centre for Pneumology and Thoracic Surgery, Großhansdorf, Germany

CORRESPONDENCE: H. Magnussen, Hospital Großhansdorf, Centre for Pneumology and Thoracic Surgery, Wöhrendamm 80, D-22927, Großhansdorf, Germany. Fax: 49 4102601245. E-mail: magnussen@pulmoresearch.de

Keywords: exercise-induced asthma, formoterol, protection, salmeterol, terbutaline

Received: March 22, 2001
Accepted November 23, 2001

This study was supported by Astra GmbH, Wedel, Germany.

The onset of bronchoprotection as obtained by various ß₂-agonists has not been examined in a comparitive study. In this study, the onset of bronchodilation and protection against exercise-induced bronchoconstriction in asthmatics after inhalation of the long-acting ß₂-agonists formoterol and salmeterol and the short-acting ß₂-agonist terbutaline were measured.

Twenty-five subjects with asthma and a history of exercise-induced bronchoconstriction (mean baseline forced expiratory volume in one second (FEV₁): 90% predicted; mean fall in FEV₁ after exercise: 31% from baseline) were enrolled in this double-blind, double-dummy, placebo-controlled, randomized, four-period crossover study. Exercise challenges were performed on 12 days at either 5, 30, or 60 min after inhalation of a single dose of formoterol (12 µg Turbuhaler®), salmeterol (50 µg Diskus®), terbutaline (500 µg Turbuhaler®) or placebo.

Exercise-induced bronchoconstriction (maximum fall in FEV₁ or area under the curve) did not differ significantly between terbutaline, formorerol and salmeterol either 5, 30, or 60 min after inhalation of the study medication. In contrast, the onset of bronchodilation was slower after salmeterol compared to terbutaline and formoterol (p<0.05, each), which both showed a similar time course. At all time points between 5 and 60 min, formoterol provided significantly greater bronchodilation than salmeterol (p<0.05).

These data indicate that equipotent doses of the bronchodilators salmeterol, formoterol and terbutaline were similarly effective with respect to their short-term protective potency against exercise-induced bronchoconstriction, despite the fact that the time course of bronchodilation was significantly different between the three ß₂-agonists.