The Effects of Fluticasone with or without Salmeterol on Systemic Biomarkers of Inflammation in Chronic Obstructive Pulmonary Disease

Small studies have suggested that inhaled corticosteroids can suppress systemic inflammation in chronic obstructive pulmonary disease (COPD). To determine the effect of inhaled corticosteroids with or without long-acting beta(2)-adrenergic agonist on systemic biomarkers of inflammation. We conducted...

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Veröffentlicht in:American journal of respiratory and critical care medicine 2008-06, Vol.177 (11), p.1207-1214
Hauptverfasser: Sin, Don D, Man, S. F. Paul, Marciniuk, Darcy D, Ford, Gordon, FitzGerald, Mark, Wong, Eric, York, Ernest, Mainra, Rajesh R, Ramesh, Warren, Melenka, Lyle S, Wilde, Eric, Cowie, Robert L, Williams, Dave, Gan, Wen Q, Rousseau, Roxanne, ABC (Advair, Biomarkers in COPD) Investigators
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container_end_page 1214
container_issue 11
container_start_page 1207
container_title American journal of respiratory and critical care medicine
container_volume 177
creator Sin, Don D
Man, S. F. Paul
Marciniuk, Darcy D
Ford, Gordon
FitzGerald, Mark
Wong, Eric
York, Ernest
Mainra, Rajesh R
Ramesh, Warren
Melenka, Lyle S
Wilde, Eric
Cowie, Robert L
Williams, Dave
Gan, Wen Q
Rousseau, Roxanne
ABC (Advair, Biomarkers in COPD) Investigators
description Small studies have suggested that inhaled corticosteroids can suppress systemic inflammation in chronic obstructive pulmonary disease (COPD). To determine the effect of inhaled corticosteroids with or without long-acting beta(2)-adrenergic agonist on systemic biomarkers of inflammation. We conducted a double-blind randomized placebo-controlled trial across 11 centers (n = 289 patients with FEV(1) of 47.8 +/- 16.2% of predicted) to compare the effects of inhaled fluticasone alone or in combination with salmeterol against placebo on circulating biomarkers of systemic inflammation over 4 weeks. The primary endpoint was C-reactive protein (CRP) level. Secondary molecules of interest were IL-6 and surfactant protein D (SP-D). Neither fluticasone nor the combination of fluticasone/salmeterol had a significant effect on CRP or IL-6 levels. There was, however, a significant reduction in SP-D levels with fluticasone and fluticasone/salmeterol compared with placebo (P = 0.002). Health status also improved significantly in both the fluticasone and fluticasone/salmeterol groups compared with placebo, driven mostly by improvements in the symptom scores. Changes in the circulating SP-D levels were related to changes in health status scores. FEV(1) improved significantly only in the fluticasone/salmeterol group compared with placebo. ICS in conjunction with long-acting beta(2)-adrenergic agonist do not reduce CRP or IL-6 levels in serum of patients with COPD over 4 weeks. They do, however, significantly reduce serum SP-D levels. These data suggest that these drugs reduce lung-specific but not generalized biomarkers of systemic inflammation in COPD.
doi_str_mv 10.1164/rccm.200709-1356OC
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F. Paul ; Marciniuk, Darcy D ; Ford, Gordon ; FitzGerald, Mark ; Wong, Eric ; York, Ernest ; Mainra, Rajesh R ; Ramesh, Warren ; Melenka, Lyle S ; Wilde, Eric ; Cowie, Robert L ; Williams, Dave ; Gan, Wen Q ; Rousseau, Roxanne ; ABC (Advair, Biomarkers in COPD) Investigators</creator><creatorcontrib>Sin, Don D ; Man, S. F. Paul ; Marciniuk, Darcy D ; Ford, Gordon ; FitzGerald, Mark ; Wong, Eric ; York, Ernest ; Mainra, Rajesh R ; Ramesh, Warren ; Melenka, Lyle S ; Wilde, Eric ; Cowie, Robert L ; Williams, Dave ; Gan, Wen Q ; Rousseau, Roxanne ; ABC (Advair, Biomarkers in COPD) Investigators ; ABC (Advair, Biomarkers in COPD) Investigators</creatorcontrib><description>Small studies have suggested that inhaled corticosteroids can suppress systemic inflammation in chronic obstructive pulmonary disease (COPD). To determine the effect of inhaled corticosteroids with or without long-acting beta(2)-adrenergic agonist on systemic biomarkers of inflammation. We conducted a double-blind randomized placebo-controlled trial across 11 centers (n = 289 patients with FEV(1) of 47.8 +/- 16.2% of predicted) to compare the effects of inhaled fluticasone alone or in combination with salmeterol against placebo on circulating biomarkers of systemic inflammation over 4 weeks. The primary endpoint was C-reactive protein (CRP) level. Secondary molecules of interest were IL-6 and surfactant protein D (SP-D). Neither fluticasone nor the combination of fluticasone/salmeterol had a significant effect on CRP or IL-6 levels. There was, however, a significant reduction in SP-D levels with fluticasone and fluticasone/salmeterol compared with placebo (P = 0.002). Health status also improved significantly in both the fluticasone and fluticasone/salmeterol groups compared with placebo, driven mostly by improvements in the symptom scores. Changes in the circulating SP-D levels were related to changes in health status scores. 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Health status also improved significantly in both the fluticasone and fluticasone/salmeterol groups compared with placebo, driven mostly by improvements in the symptom scores. Changes in the circulating SP-D levels were related to changes in health status scores. FEV(1) improved significantly only in the fluticasone/salmeterol group compared with placebo. ICS in conjunction with long-acting beta(2)-adrenergic agonist do not reduce CRP or IL-6 levels in serum of patients with COPD over 4 weeks. They do, however, significantly reduce serum SP-D levels. These data suggest that these drugs reduce lung-specific but not generalized biomarkers of systemic inflammation in COPD.</abstract><cop>New York, NY</cop><pub>Am Thoracic Soc</pub><pmid>18310480</pmid><doi>10.1164/rccm.200709-1356OC</doi><tpages>8</tpages></addata></record>
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identifier ISSN: 1073-449X
ispartof American journal of respiratory and critical care medicine, 2008-06, Vol.177 (11), p.1207-1214
issn 1073-449X
1535-4970
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source MEDLINE; American Thoracic Society (ATS) Journals Online; Alma/SFX Local Collection; EZB Electronic Journals Library; Journals@Ovid Complete
subjects Administration, Inhalation
Adrenergic beta-Agonists - administration & dosage
Adrenergic receptors
Aged
Albuterol - administration & dosage
Albuterol - analogs & derivatives
Androstadienes - administration & dosage
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anti-Inflammatory Agents - administration & dosage
Biological and medical sciences
Biomarkers
Biomarkers - metabolism
C-Reactive Protein - metabolism
Canada
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease, asthma
Clinical outcomes
Clinical trials
Double-Blind Method
Drug Combinations
Female
Fluticasone
Fluticasone-Salmeterol Drug Combination
Humans
Inflammation
Intensive care medicine
Interleukin-6 - metabolism
Male
Medical sciences
Middle Aged
Mortality
Pneumology
Proteins
Pulmonary Disease, Chronic Obstructive - drug therapy
Pulmonary Disease, Chronic Obstructive - metabolism
Pulmonary Disease, Chronic Obstructive - pathology
Pulmonary Surfactant-Associated Protein D - metabolism
Respiratory Function Tests
Steroids
Surfactants
Treatment Outcome
title The Effects of Fluticasone with or without Salmeterol on Systemic Biomarkers of Inflammation in Chronic Obstructive Pulmonary Disease
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