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Anti-inflammatory effects of salmeterol/fluticasone, tiotropium/fluticasone or tiotropium in COPD

¹ Dept of Chest Medicine, Taipei Veterans General Hospital, ² School of Medicine, National Yang-Ming University, and ³ Cheng Hsin Rehabilitation Medical Center, Taipei, Taiwan, ⁴ These authors contributed equally to the study.

CORRESPONDENCE: D-W. Perng, School of Medicine, National Yang-Ming University, Department of Chest Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan. Fax: 886 228761009. E-mail: dwperng{at}vghtpe.gov.tw

Keywords: Chronic obstructive pulmonary disease, inflammation, interleukin-8, matrix metalloprotease, salmeterol/fluticasone, tiotropium

Received: July 29, 2008
Accepted December 4, 2008

The anti-inflammatory effects of salmeterol/fluticasone (SFP), tiotropium/fluticasone (Tio+FP) and tiotropium (Tio) alone were investigated on the inflammatory cells and mediators in sputum induced from chronic obstructive pulmonary disease patients.

Subjects were either newly diagnosed or had not taken any medication for 3 months prior to the study. Subjects (n = 99) were randomised (not double blinded) and received either SFP (100/1,000 µg daily), Tio+FP (18/1,000 µg daily) or Tio (18 µg daily) for 12 weeks. Induced sputum and serum C-reactive protein (CRP) were analysed prior to and at the end of treatment.

The results showed that treatment with SFP caused a significant reduction in interleukin (IL)-8 and matrix metalloprotease (MMP)-9 in induced sputum, compared with treatment with Tio alone. There were no treatment differences between the SFP and Tio+FP groups in decreasing IL-8 and MMP-9 levels. The reduction in IL-8 showed significant association with the reduction in MMP-9. All treatment groups failed to significantly reduce the numbers of total cells, neutrophils, macrophages and eosinophils in induced sputum; in addition, there were no treatment differences in terms of improvement of forced expiratory volume in one second, forced vital capacity, CRP or quality of life between the three groups.

The anti-inflammatory effects of salmeterol/fluticasone probably contribute to the clinical benefits seen in chronic obstructive pulmonary disease patients.