The effect of inhaled salmeterol, alone and in combination with fluticasone propionate, on management of COPD patients Fariba Mansori 1 , Anaiatolah Nemat Khorasani 2 , Mohammad Hossein Boskabady 3 and Morteza Boskabady 3 1 Department of Medicine, Medical School, Kermanshah University of Medical Sciences, Mashhad, Iran 2 Department of Pediatrics, Medical School, Kermanshah University of Medical Sciences, Mashhad, Iran 3 Department of Physiology, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran Abstract Introduction: Airway inflammation is a known pathological feature of chronic obstructive pulmonary disease (COPD). We examined the effect of inhaled salme- terol, alone and in combination with fluticasone propionate, on the management of patients with COPD. Methods: Forty male COPD patients were randomly divided into two groups; group 1 (n = 20) were treated with long-acting ß2-agonist, and group 2 (n = 20) with long-acting ß2-agonist and inhaled glucocoticoid each day for 3 months. Pulmonary function tests (PFTs), including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF), were measured at the beginning, 1 and 2 months after treatment and at the end of the study. The frequency of using inhaled salbutamol/day and the 6-min walk distance were also measured at four different visits. The frequency of exacerbation was also recorded during the 90-day treatment period in the two groups. Results: FEV1, FVC and PEF were significantly higher after 30 days of treatment with fluticasone propionate (mean change from baseline in group 2: 155 mL, 200 mL and 70 L/s, respectively; P < 0.001). Six-minute walk distance also increased significantly (mean change from baseline: 160 m; P < 0.001), and there was a 70%–80% reduction in the use of inhaled salbutamol (P < 0.001). All improvements were maintained over the remainder of the study period. Exacerba- tions over the 90-day treatment period were significantly fewer than in the same 90-day period in the previous year (2.8  0.7 vs 0.8  0.9; P < 0.001). In contrast, only PEF increased significantly with treatment in group 1 (salmeterol treatment alone). Conclusions: These results indicated that inhaled corticosteroids may be beneficial in some patients with COPD. Please cite this paper as: Mansori F, Nemat Khorasani A, Boskabady MH and Boskabady M. The effect of inhaled salmeterol, alone and in combination with fluticasone propionate, on management of COPD patients. Clin Respir J 2010; 4: 241–247. Key words COPD – inhaled glucocoticoid – long-acting b2-agonist – pulmonary function tests – six-minute walk Correspondence Mohammad Hossein Boskabady, MD, PhD, Department of Physiology, Medical School Mashhad 9177948564, Iran. Tel: +98 511 8828565 Fax: +98 511 8828564 email: boskabadymh@mums.ac.ir, mhboskabady@hotmail.com Received: 21 December 2009 Revision requested: NA Accepted: 27 December 2009 DOI:10.1111/j.1752-699X.2010.00185.x Authorship: Fariba Mansouri: Designing of the study, recruiting patients and allocating them in two groups. Enyatollah Nemat Khorasani: Helped in the design of the study, administration of the drugs and flow up the patients. Mohammad Hossein Boskabady: Helped in the design of the study, statistical analysis of the data, interpretation of the data and preparation of the manuscript. Morteza Boskabady: Helped in the design of the study, statistical analysis of the data and preparation of the manuscript. Ethics The protocol was approved by the Ethics Committee of Kermanshah University of Medical Sciences, and each subject gave informed consent. Conflict of interest The authors have stated explicitly that there are no conflicts of interest in connection with this article. The Clinical Respiratory Journal ORIGINAL ARTICLE 241 The Clinical Respiratory Journal (2010) • ISSN 1752-6981 © 2010 Blackwell Publishing Ltd