Comparison of Treatment of Salmeterol and Formoterol with Fluticasone on Quality of Life (QOL) of Patients Suffering from Chronic Obstructive Pulmonary Disease (COPD)
Background: Chronic obstructive pulmonary disease (COPD) is characterized by symptoms of dyspnoea, paroxysmal coughing, fatigue, and insomnia associated with considerable impact on quality of life of patients. Inhaled corticosteroid/long-acting β2-agonist combinations (ICS/LABA) are endorsed for maintenance therapy for COPD. So, we designed this study to compare the treatment of combination of salmeterol or formoterol with fluticasone on Quality of life (QOL) of patients suffering from chronic obstructive pulmonary disease (COPD). Methods: This prospective, randomized, parallel group study was conducted 45 patients suffering from COPD were enrolled in the study after they signed a written informed consent. The patients were divided in two groups based on the treatment in two groups. Group 1 was on treatment with salmeterol with fluticasone whereas group 2 was on treatment with formoterol with fluticasone; they were assessed at baseline and 4weeks. Patients were subjected to St George Respiratory Questionnaire (SGRQ) and WHO – Quality of life (WHO-QOL Bref) Questionnaire. Results: A total of 24 patients in group 1 and 21 patients in group 2 completed the study. The demographic profile of patients was comparable at baseline. Patients in both groups had showed a statistically significant improvement in symptoms score as compared to baseline as is evident by lower scores in SGRQ and high scores in WHO-QOL Bref score Patients on formoterol and fluticasone had slightly better scores as compared to the other group though it was not statistically significant. Conclusions: Both the treatment showed significant improvement in symptoms as well as quality of life as compared to baseline and a combination of formoterol and fluticasone was slightly better as compared to combination of salmeterol and fluticasone.
2. Deepak TH, Mohapatra PR, Janmeja AK, Sood P, Gupa M. Outcome of pulmonary rehabilitation in patients after acute exacerbation of chronic obstructive pulmonary disease. Indian J Chest Dis Allied Sci 2014; 56: 7-12.
3. Van Isselt EFD, Groenewegen-Sipekma KH, Eijk MSE, Chavannes NH, de Waal MWM, Janssen DJA, et.al. Pain in patients with COPD a systemic review and meta-analysis. BMJ Open 2014; 4: e005898.
4. Kern DM, Davis J, Williams SA, Tunceli O, Wu B, Hollis S, et.al. Comparative effectiveness of budesonide/formoterol combination and fluticasone/salmeterol combination among chronic obstructive pulmonary disease patients new to controller treatment: A US administrative claims database study. Respiratory Research 2015; 16: 52.
5. Cope S, Donohue JF, Jansen JP, Kraemer M, Capkun-Niggli G, Baldwin M, et.al. Comparative efficacy of long-acting bronchodilators for COPD – a network meta-analysis. Respiratory Research 2013; 14: 100.
6. COPD Statistical Information. Available on url. http://www.copd-international.com/library/statistics.htm
7. Murthy KJR, Sastry JG. Economic burden of chronic obstructive pulmonary disease. NCMH Background Papers – Burden of Disease in India. Available on url. http://whoindia.org/LinkFiles/Commision_on_Macroeconomic_and_Health_Bg_P2_Economic_burden_of_chronic_obstructive_pulmonary_disease.pdf
8. Blumenthal JA, Keefe FJ, Babyak MA, Fenwick CV, Johnson JM, Stott K, et. al. Caregiver-assisted coping skills for patients with COPD: background, design, and methodological issues for the INSPIRE-II study. Clin Trials 2009; 6: 172-184. Doi: 10.1177/1740774509102565.
9. Bender BG, Vecino RAH, McGrath K, Jones S. Comparative analysis of persistence to treatment among patients with asthma
or COPD receiving airflusal forspiro or seretide diskus salmeterol/ fluticasone propionate combination therapy. J Allergy Clin Immunol Pract 2016; 4: 884-9.
10. Kolasani BP, Mudium R, Diyya S. Indacaterol and salmeterol in COPD patients: A comparative study of efficacy and safety. Int J Basic Clin Pharmacol 2013; 2: 421-7.
11. Jones PW, Quirk FH, Baveystock CM. The St. George’s Respiratory Questionnaire. Respir Med 1991; 85 (Suppl B): 25-31
12. Jones PW, Quirk FH, Baveystock CM, Littlejohns P. A self-complete measure for chronic airflow limitation – the St. George’s Respiratory Questionnaire. Am Rev Respir Dis 1992; 145: 1321-1327
13. Meguro M, Barley EA, Spencer S, Jones PW. Development and validation of an improved COPD-Specific version of the St. George’s Respiratory Questionnaire. Chest 2006; 132: 456-463.
14. Skevington SM, Lotfy M, O' Connell KA, the WHO QOL Group. The World Health Organization's WHO QOL Bref quality of life assessment: psychometric properties and results of the international field trial. A report from the WHO QOL group. Qual Life Res 2004; 13: 299-310.
15. Anees M, Hameed F, Mumtaz A, et al. Dialysis-related factors affecting quality of life in patients on haemodialysis. Iranian J Kidney Dis 2011; 5: 9-14.
16. Tricco AC, Strifler L, Veroniki AA, Yazdi F, Khan PA, Scott A, et.al. Comparative safety and effectiveness of long-acting inhaled agents for treating chronic obstructive pulmonary disease: A systematic review and network meta-analysis. BMJ Open 2015; 5; e009183.