The Effects of Switching from Fluticasone/Salmeterol Aerosol to Fluticasone/Formoterol Aerosol in Patients with Severe Asthma

Objective: Two pressurized Metered Dose Inhalers (pMDIs) containing a combination of a corticosteroid and long acting β2 agonist: Fluticasone propionate/Salmeterol Combination (FSC), and Fluticasone propionate/Formoterol Combination (FFC), are currently available in Japan. In order to examine the usefulness of the FFC pMDI, we sought to investigate the efficacy, adverse events, and handling after switching to the FFC pMDI from the FSC in patients with asthma. Methods: Fifty-six outpatients who were using the FSC pMDI (250/50 μg) twice daily were enrolled in the study. The following items were evaluated before and after the use of the FFC pMDI (250/10 μg) twice daily for 8 weeks: Asthma Control Test (ACT) Questionnaire; Asthma Health Questionnaire (AHQ)-33-Japan; spirometry; and forced oscillation technique. On the final day of the study, the original questionnaire was administered for a subjective evaluation between the FSC pMDI and FFC pMDI. Results: We found improvements in ACT (22.54 to 22.98, p=0.0076) and AHQ-33 Japan (16.27 to 14.23, p=0.0162) scores after FFC use. In addition, inspiratory capacity (p <0.0001) and forced expiratory volume in 1 second (p=0.0122) significantly increased. Further, 51.8% of patients preferred the FFC, while 12.5% preferred the FSC. Conclusion: There was a subjective and objective improvement in patients after switching to FFC pMDI from FSC pMDI. These findings indicate that FFC is more useful for patients with asthma. Further studies are needed to confirm the results of this study.