Theophilus, A., Moore, A., Prime, D., Rossomanno, S., Whitcher, B. and Chrystyn, Henry (2006) Co-deposition of salmeterol and fluticasone propionate by a combination inhaler. International Journal of Pharmaceutics, 313. pp. 14-22. ISSN 0378-5173
Restricted to Registered users only
The combination of the long-acting β2-agonist, salmeterol xinafoate (salmeterol) and inhaled corticosteroid, fluticasone propionate (FP) (Seretide®/Advair®) has shown enhanced efficacy compared with concurrent administration of the two drugs from individual inhalers at the same dose. A possible explanation for this increased effect is a higher degree of co-deposition of the two drugs from the combination (Seretide) inhaler compared with the component drugs administered separately.
Raman laser spectroscopy, a technique capable of identifying individual drug particles, has been used with novel statistical methodology that we have developed, to determine whether there is any co-association between drug particles and whether this occurs in the Seretide formulation rather than by chance. Samples from a combined Seretide metered dose inhaler (MDI, 25/50 mcg) and salmeterol (25 mcg) with FP (50 mcg) from separate MDI's taken from Plate 4 of an Anderson Cascade Impactor were analysed.
Using a statistical test based on the bootstrap technique, it was found that the co-deposition of FP and salmeterol particles from the combination MDI was significantly greater than from the separate inhalers group (p < 0.001). A higher degree of co-deposition on the same cells of the airways may possibly account for the increased efficacy observed in patients prescribed Seretide MDI.
|Additional Information:||Copyright © 2006 Elsevier B.V. All rights reserved.|
|Uncontrolled Keywords:||Synergy; Salmeterol; Fluticasone propionate; Combination therapy|
|Subjects:||R Medicine > RS Pharmacy and materia medica|
|Schools:||School of Applied Sciences|
Adcock et al., 2002 I.M. Adcock, K. Maneechotesuwan and O. Usmani, Molecular interactions between glucocorticoids and long-acting beta2-agonists, J. Allergy Clin. Immunol. 110 (2002), pp. S261–S268. Abstract | PDF (216 K) | View Record in Scopus | Cited By in Scopus (34)
Aggarwal et al., 2003 S.K. Aggarwal, L.J. Frith, M. Ho, T.C. Weeks and S.Y. Ho, Fluticasone propionate/salmeterol delivered from a single inhaler demonstrates synergistic benefits in asthma, Am. J. Respir. Crit. Care Med. 167 (2003), p. A890.
Andersen, 1985 Andersen Samplers Inc. Operating Manual for Andersen 1 ACFM Non-Viable Ambient Particle Sizing Samplers, 1985. Published by Andersen Samplers Inc. Atlanta, GA, USA.
Ashurst et al., 1998 I.C. Ashurst, D. Prime and P.A. Haywood, Development of a dry powder inhaler device containing a combination of salmeterol and fluticasone propionate, Eur. Respir. J. 12 (1998), p. 93s.
Aubier et al., 1999 M. Aubier, W. Pieters, N. Schlosser and K.-O. Steinmetz, Salmeterol/fluticasone propionate (50/500 mcg) in combination on a Diskus inhaler (Seretide) is effective and safe in the treatment of steroid dependent asthma, Respir. Med. 93 (1999), pp. 876–884. SummaryPlus | Full Text + Links | PDF (1025 K) | View Record in Scopus | Cited By in Scopus (87)
Baraniuk et al., 1997 J.N. Baraniuk, M. Ali, D. Brody, J. Maniscalco, E. Gaumond, T. Fitzgerald, G. Wong, A. Yuta, J.C. Mak, P.J. Barnes, R. Bascom and T. Troost, Glucocorticoids induce beta2-adrenergic receptor function in human nasal mucosa, Am. J. Respir. Crit. Care Med. 155 (1997), pp. 704–710. View Record in Scopus | Cited By in Scopus (64)
Barnes, 2002 P.J. Barnes, Scientific rationale for inhaled combination therapy with long-acting beta2-agonists and corticosteroids, Eur. Respir. J. 19 (2002), pp. 182–191. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (165)
Bateman et al., 1998 E.D. Bateman, M. Britton, J. Carrillo, J. Almeida and C. Wixon, Salmeterol/fluticasone (50/100 mcg) combination inhaler. A new, effective and well-tolerated treatment for asthma, Clin. Drug Invest. 16 (1998), pp. 193–201. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (48)
Bateman et al., 2001 E.D. Bateman, V. Silins and M. Bogolubov, Clinical equivalence of salmeterol/fluticasone propionate in combination (50/100 mcg twice daily) when administered via a chlorofluorocarbon-free metered dose inhaler or dry powder inhaler to patients with mild-to-moderate asthma, Respir. Med. 95 (2001), pp. 136–146. Abstract | Abstract + References | PDF (197 K) | View Record in Scopus | Cited By in Scopus (18)
British Pharmacopoeia, 2002 British Pharmacopoeia, 2002. General Monographs, Preparations for Inhalation.
BTS, 2004 British Guideline on the Management of Asthma, 2004. Update April 2004. http://www.brit-thoracic.org.uk/.
Chapman et al., 1999 K.R. Chapman, N. Ringdal, V. Backer, M. Palmqvist, S. Saarelainen and M. Briggs, Salmeterol and fluticasone propionate (50/250 mcg) administered via combination Diskus inhaler: as effective as when given via separate Diskus inhalers, Can. Respir. J. 6 (1999), pp. 45–51. View Record in Scopus | Cited By in Scopus (66)
Davison and Hinkley, 1997 A.C. Davison and D.V. Hinkley, Bootstrap Methods and their Applications, Cambridge University Press, Cambridge, England (1997).
Emeryk et al., 2003 A. Emeryk, T. Bracomonte, U. Schauer, S. Balsara and R. Athisegaran, Efficacy of salmeterol/fluticasone propionate (50/100 mcg/day) delivered via the Diskus and MDI in children with asthma, Eur. Respir. J. 22 (2003), p. 1985.
Fraser Steele et al., 2004 D. Fraser Steele, P.M. Young, R. Price, T. Smith, S. Edge and D. Lewis, The potential use of Raman mapping to investigate deposition of combination pressurized metered-dose inhalers, AAPS J. 6 (2004) Article 21 (http://www.aapsj.org)..
GOLD, 2003 Global Initiative for Chronic Obstructive Lung Disease (GOLD), 2003. Publication no. 2701. National Institutes for Health, Bethesda, 2001 (2003 update).
Greening et al., 1994 A.P. Greening, P. Ind, M. Northfield and G. Shaw, Added salmeterol versus higher-dose corticosteroid in asthma patients with symptoms on existing inhaled corticosteroid, Lancet 344 (1994), pp. 219–224. Abstract | Full Text + Links | PDF (881 K) | View Record in Scopus | Cited By in Scopus (597)
GDMA, 1997 Guidelines for the Diagnosis and Management of Asthma, 1997. Expert panel report 2. National Institutes of Health, National Heart, Lung and Blood Institute, July 1997. NIH publication number 97-4051.
Johnson, 2002 M. Johnson, Combination therapy for asthma: complementary effects of long-acting ß2-agonists and corticosteroids, Curr. Allergy Clin. Immunol. 15 (2002), pp. 16–22.
Kirby et al., 2000 S. Kirby, C. Falcoz, M.J. Daniel, S. Milleri, L. Squassante, L. Ziviani and G.P. Ventresca, Salmeterol and fluticasone propionate given as a combination: lack of systemic pharmacodynamic and pharmacokinetic interactions, Eur. J. Clin. Pharmacol. 56 (2000), pp. 781–791.
Mak et al., 1995 J.C. Mak, M. Nishikawa and P.J. Barnes, Glucocorticosteroids increase B2-adrenergic receptor transcription in human lung, Am. J. Physiol. 268 (1995), pp. L41–L46. View Record in Scopus | Cited By in Scopus (130)
Malley et al., 1998 T.R. Malley, I.C. Ashurst, G.E. Daniels, D. Prime, N.J. Stock and P.A. Haywood, Fine particle mass of a dry powder inhaler device containing a combination of salmeterol and fluticasone propionate, Eur. Respir. J. 12 (1998), p. 8s.
Matz et al., 2001 J. Matz, A. Emmett, K. Rickard and C. Kalberg, Addition of salmeterol to low-dose fluticasone versus higher-dose fluticasone: an analysis of asthma exacerbations, J. Allergy Clin. Immunol. 107 (2001), pp. 783–789. Abstract | PDF (168 K) | View Record in Scopus | Cited By in Scopus (65)
Michael et al., 2001 Y. Michael, M.J. Snowden, B.Z. Chowdhry, I.C. Ashurst, C. Davies-Cutting and T. Riley, Characterisation of the aggregation behaviour in a salmeterol and fluticasone propionate inhalation aerosol system, Int. J. Pharm. 221 (2001), pp. 165–174. SummaryPlus | Full Text + Links | PDF (177 K) | View Record in Scopus | Cited By in Scopus (13)
Miller and Miller, 1993 Miller, J.C., Miller, J.N., 1993. Statistics for Analytical Chemistry, 3rd ed. Ellis Horwood PRT Prentice Hall, Analytical Chemistry Series.
Nelson et al., 2003 H. Nelson, K.R. Chapman, S.D. Pyke, M. Johnson and J.N. Pritchard, Enhanced synergy between fluticasone propionate and salmeterol inhaled from a single inhaler versus separate inhalers, J. Allergy Clin. Immunol. 112 (2003), pp. 29–36. Abstract | PDF (156 K) | View Record in Scopus | Cited By in Scopus (54)
Roth et al., 2002 M. Roth, P.R. Johnson, J.J. Rudiger, G.G. King, Q. Ge, J.K. Burgess, G. Anderson, M. Tamm and J.L. Black, Interaction between glucocorticoids and beta2 agonists on bronchial airway smooth muscle cells through synchronised cellular signalling, Lancet 360 (2002), pp. 1265–1266.
Shrewsbury et al., 2000 S. Shrewsbury, S. Pyke and M. Britton, Meta-analysis of increased dose of inhaled steroid or addition of salmeterol in symptomatic asthma (MIASMA), Br. Med. J. 320 (2000), pp. 1368–1373. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (245)
Sokal and Sneath, 1963 R.R. Sokal and P.H. Sneath, Principles of Numerical Taxonomy, W.H. Freeman, San Francisco (1963).
Swenson et al., 2003 C. Swenson, J. Laseman and W. Busse, Combination of salmeterol (SAL) and Fluticasone (FP) works synergistically to inhibit airway inflammation post allergen challenge, J. Allergy Clin. Immunol. 111 (2003), p. S126. Abstract | PDF (129 K)
Van den Berg et al., 2000 N.J. Van den Berg, M. Ossip, C.A. Hederos, H. Anttila, B.L. Ribeiro and P.I. Davies, Salmeterol/fluticasone propionate (50/100 mcg) in combination in a Diskus inhaler (Seretide) is effective and safe in children with asthma, Paediat. Pulmonol. 30 (2000), pp. 97–105. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (61)
van Noord et al., 2001 J.A. van Noord, H. Lill, T. Carrillo Diaz, A.P. Greefhorst and P. Davies, Clinical equivalence of salmeterol/fluticasone propionate combination product (50/500 g) delivered via a chlorofluorocarbon-free metered dose inhaler with the Diskus in patients with moderate to severe asthma, Clin. Drug Invest. 21 (2001), pp. 243–255. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (9)
Woolcock et al., 1996 A. Woolcock, B. Lundback, N. Ringdal and L.A. Jacques, Comparison of addition of salmeterol to inhaled steroids with doubling of the dose of inhaled steroids, Am. J. Respir. Crit. Care Med. 153 (1996), pp. 1481–1488.
Young et al., 2004 P.M. Young, R. Price, S. Jones and M. Parry-Billings, Investigation into drug and excipient interaction in dry powder inhaler combination products, Proc. Respir. Drug Deliv. IX 3 (2004), pp. 749–752.
Zetterström et al., 2001 O. Zetterström, R. Buhl, H. Mellem, M. Perpiñà, J. Hedman, S. O’Neill and T. Ekstrom, Improved asthma control with budesonide/formoterol in a single inhaler, compared with budesonide alone, Eur. Respir. J. 18 (2001), pp. 262–268. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (90)
|Depositing User:||Briony Heyhoe|
|Date Deposited:||09 Oct 2007|
|Last Modified:||28 Jul 2010 18:21|
Downloads per month over past year
Repository Staff Only: item control page