Clinical Drug Investigation

, Volume 21, Issue 4, pp 243–255

Clinical Equivalence of a Salmeterol/Fluticasone Propionate Combination Product (50/500μg) Delivered via a Chlorofluorocarbon-Free Metered-Dose Inhaler with the Diskus™ in Patients with Moderate to Severe Asthma

  • J. A. van Noord
  • H. Lill
  • T. Carrillo Diaz
  • A. P. Greefhorst
  • P. Davies
Clinical Use

DOI: 10.2165/00044011-200121040-00002

Cite this article as:
van Noord, J.A., Lill, H., Diaz, T.C. et al. Clin. Drug Investig. (2001) 21: 243. doi:10.2165/00044011-200121040-00002



To demonstrate equivalent efficacy and comparable tolerability of two inhaled combined formulations of salmeterol/fluticasone propionate (SALM/FP) 50/500μg twice daily in asthma patients.

Design and Setting

Multicentre, double-blind, parallel-group study.


Patients aged 12 to 82 years with moderate to severe asthma who were symptomatic on existing inhaled corticosteroid therapy.


176 patients were randomised to SALM/FP 50/500μg twice daily via a novel hydrofluoroalkane (HEA) metered-dose inhaler (MDI; 25/250μg per actuation), and 161 received the same dosage of SALM/FP via a dry powder Diskus™ inhaler (50/500μg) for 12 weeks. A third group of patients (n = 172) received the same dosage of steroid, FP 500μg twice daily, alone via a chlorofluorocarbon (CFC) MDI (250μg per actuation). The primary efficacy parameter was change in morning peak expiratory flow (PEF) over weeks 1 to 12.


The SALM/FP MDI was clinically equivalent to the SALM/FP Diskus™ for the mean change in morning PEF over weeks 1 to 12 [adjusted mean increases 50 and 48 L/min, respectively; treatment difference −2 L/min; 95% confidence interval (CI):−11 to 7 L/min]. The SALM/FPMDI produced significantly greater improvements in morning PEF than the FPMDI (difference: −23 L/min; 95% CI: −32 to −14), with superiority for all secondary efficacy measures. All three treatments were well tolerated, with similar profiles and incidences of adverse events.


At a dosage of 50/500μg twice daily, the SALM/FP 25/250μg HFA MDI (two actuations twice daily) is clinically equivalent to the SALM/FP 50/500μg Diskus™ (one actuation twice daily). The availability of two formulations offers patients a choice of delivery systems when switching to combination therapy with SALM/FP.

Copyright information

© Adis International Limited 2001

Authors and Affiliations

  • J. A. van Noord
    • 1
  • H. Lill
    • 2
  • T. Carrillo Diaz
    • 3
  • A. P. Greefhorst
    • 4
  • P. Davies
    • 5
  1. 1.Atrium HospitalHeerlenThe Netherlands
  2. 2.Tartu University Lung ClinicTartuEstonia
  3. 3.Servicio de AlergiaHospital de Gran Canaria Doctor NegrinLas Palmas de Gran CanariaSpain
  4. 4.GeerdinkswegHengeloThe Netherlands
  5. 5.Respiratory Therapeutic DevelopmentGlaxo Wellcome Research and DevelopmentUxbridgeEngland
  6. 6.PC HeerlenThe Netherlands