Comparison of the clinical efficacy and safety of salmeterol/fluticasone propionate versus current care in the management of persistent asthma in Korea

Objectives: In the Asia-Pacific region there is a general preference for prescribing oral over inhaled medications for the treatment of asthma. This study compared inhaled salmeterol/fluticasone propionate therapy (SFC) with physician-determined current care (CC) in the management of persistent asthma in Korea. Methods: Adult patients with a documented history of reversibility in FEV₁ (≥12%) or PEF (≥15%), were randomised in a 2:1 ratio to unblinded treatment with SFC (50/250 μg bd or 50/500 mg bd) via Diskus (N=284) or CC (N=140) for 52 weeks. Morning peak expiratory flow (PEF) (primary endpoint), exacerbations, asthma symptoms and patient-reported outcome measures were recorded. Trial registration: GSK study number:100614. Results: At baseline, mean morning PEF in the SFC and CC group was 374 and 401 L/min respectively. The adjusted mean morning PEF at 52 weeks was 423±3 and 396±4 L/min for SFC and CC respectively (treatment difference of 27±5 in favour of SFC; 95% CI 17, 37; p<0.0001). The mean rate of exacerbations over 52 weeks was significantly lower in the SFC group (SFC/CC odds ratio 0.57; 95% CI 0.44, 0.74; p<0.0001). Treatment with SFC also resulted in a significantly greater improvement in asthma symptoms, in the number of patients assessed to have well controlled asthma (Asthma Control Test score ≥ 20), and in a clinically significant improvement in overall Quality of Life. The incidence of adverse events was low and similar between the two groups and events were of the type expected in this population. Conclusions: The results of this open-label, randomised study showed that SFC provided greater asthma control than CC in the management of persistent asthma.