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

¹ Dept of Chest Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan; and School of Medicine, National Yang-Ming University, Taipei 11217, Taiwan
² Cheng Hsin Rehabilitation Medical Center, Taipei 11217, Taiwan
³ Dept of Chest Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan

^* To whom correspondence should be addressed. E-mail: dwperng{at}vghtpe.gov.tw.

	Abstract

We investigated the anti-inflammatory effects of salmeterol/fluticasone (SFP), tiotropium/fluticasone (Tio+FP) and tiotropium (Tio) alone on the inflammatory cells and mediators in sputum induced from COPD patients.

Subjects were either newly-diagnosed or had not taken any medication for 3 months prior to the study. Subjects (N=99) were randomized (not double blinded) and received either SFP (100/1000 µg daily), Tio+FP (18 µg/1000 µg daily) or Tio (18 µg daily) for 12 weeks. Induced sputum and serum C-reactive protein (CRP) were analyzed prior to and at the end of treatment.

The results showed that treatment with SFP caused a significant reduction in interleukin-8 (IL-8) and matrix metalloprotease (MMP)-9 in induced sputum as 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 FEV₁, FVC, CRP or quality of life between three groups.

The anti-inflammatory effects of SFP likely contribute to the clinical benefits seen in COPD patients.