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Serevent Diskus. (New & Approved).

(salmeterol xinafoate inhalation powder, GlaxoSmithKline)

A long-acting [beta]-agonist, approved for maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis. Previously approved for treating asthma and preventing exercise-induced bronchospasm. This is a dry powder formulation of Serevent (salmeterol), which was approved for the same indication in 1998 as a metered-dose inhaler and is being phased out because it contains ozone-depleting chlorofluorocarbons (CFCs).

* Recommended Dosage: One inhalation (50 [micro]g each) twice a day, every 12 hours.

* Special Considerations: Not intended for acute, rescue therapy.

* Comment: In two 24-week studies of patients with chronic bronchitis with airflow limitation, with or without emphysema, those treated with Serevent Diskus had greater improvements in pulmonary function than those on placebo. The product has the same clinical effect as Serevent, which is delivered via a metered dose inhaler, but is much easier to use, said Dr. James Donohue, professor of medicine and chief of the division of pulmonary critical care, University of North Carolina, Chapel Hill. Patients can be trained to use the breath-activated device in as little as a minute, with a high success rate, he said.

Salmeterol is one of two long-acting bronchodilators approved for COPD. The other, Foradil (formoterol) also works for 12 hours, "The long-acting bronchodilators are very effective in COPD, and the inhaled route is safer than oral doses for these patients who are older and have comorbidities," he said. The bronchodilator Atrovent, an anticholinergic drug, also is an effective COPD therapy, but needs to be taken every 4 times a day, he noted.

Some physicians have a pessimistic attitude about COPD as an irreversible, self-inflicted type of condition, but Dr. Donohue emphasized that there are effective therapies such as long-acting bronchodilators that can make patients feel better. He advises physicians to wait for 4 to 8 weeks after starting a COPD patient on a long-acting bronchodilator before making any conclusion about effectiveness. "In the Serevent trials, a lot of patients who looked like they were irreversible in the beginning and didn't seem to benefit got better as the study went on," said Dr. Donohue, an investigator in those trials. He also is a consultant to GlaxoSmithKline, is on its speakers bureau, and has received research support from the company.
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Author:Mechcatie, Elizabeth
Publication:OB GYN News
Date:May 15, 2002
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