PMID- 21917440
OWN - NLM
STAT- MEDLINE
DCOM- 20120125
LR  - 20151119
IS  - 1532-3064 (Electronic)
IS  - 0954-6111 (Linking)
VI  - 105
IP  - 12
DP  - 2011 Dec
TI  - Effect of adjunct fluticasone propionate on airway physiology during rest and 
      exercise in COPD.
PG  - 1836-45
LID - 10.1016/j.rmed.2011.08.021 [doi]
AB  - RATIONALE: Combination therapy with corticosteroid and long-acting beta(2)-agonists 
      (LABA) in a single inhaler is associated with superior effects on airway function 
      and exercise performance in COPD compared with LABA monotherapy. The 
      physiological effects of adding inhaled corticosteroid monotherapy to maintenance 
      bronchodilator therapy (long-acting anticholinergics and LABA singly or in 
      combination) in COPD are unknown. METHODS: This was a randomized, double-blind, 
      placebo-controlled, crossover study (NCT00387036) to compare the effects of 
      inhaled fluticasone propionate 500 mug (FP500) twice-daily and placebo (PLA) on 
      airway function during rest and exercise, measured during constant work rate 
      cycle exercise at 75% of maximum incremental cycle work rate, in 17 patients with 
      COPD (FEV(1) </= 70% predicted). RESULTS: After treatment with FP500 compared to 
      PLA, there were significant increases in post-dose measurements of FEV(1) (+115 
      mL, P = 0.006) and the FEV(1)/FVC ratio (+2.5%, P = 0.017), along with decreases 
      in plethysmographic residual volume (-0.32L; P = 0.031), functional residual 
      capacity (-0.30L, P = 0.033), and total lung capacity (-0.30L, P = 0.027) but no 
      changes in vital capacity or inspiratory capacity (IC). Post-treatment 
      comparisons demonstrated a significant improvement in endurance time by 188 +/- 362 
      s with FP500 (P = 0.047) with no concomitant increase in dyspnea intensity. 
      End-inspiratory and end-expiratory lung volumes were reduced at rest and 
      throughout exercise with FP500 compared with PLA (P < 0.05). CONCLUSION: Inhaled 
      FP500 monotherapy was associated with consistent and clinically important 
      improvements in FEV(1), static lung volumes, dynamic operating lung volumes, and 
      exercise endurance when added to established maintenance long-acting 
      bronchodilator therapy in patients with moderate to severe COPD.
CI  - Copyright (c) 2011 Elsevier Ltd. All rights reserved.
FAU - Guenette, Jordan A
AU  - Guenette JA
AD  - Respiratory Investigation Unit, Department of Medicine, Queen's University and 
      Kingston General Hospital, Kingston, ON, Canada.
FAU - Raghavan, Natya
AU  - Raghavan N
FAU - Harris-McAllister, Veronica
AU  - Harris-McAllister V
FAU - Preston, Megan E
AU  - Preston ME
FAU - Webb, Katherine A
AU  - Webb KA
FAU - O'Donnell, Denis E
AU  - O'Donnell DE
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20110913
PL  - England
TA  - Respir Med
JT  - Respiratory medicine
JID - 8908438
RN  - 0 (Androstadienes)
RN  - 0 (Bronchodilator Agents)
RN  - CUT2W21N7U (Fluticasone)
SB  - IM
MH  - Aged
MH  - Androstadienes/pharmacology/*therapeutic use
MH  - Bronchodilator Agents/pharmacology/*therapeutic use
MH  - Cross-Over Studies
MH  - Double-Blind Method
MH  - Dyspnea/drug therapy/etiology/*physiopathology
MH  - *Exercise
MH  - Female
MH  - Fluticasone
MH  - Forced Expiratory Volume/drug effects
MH  - Humans
MH  - Male
MH  - Pulmonary Disease, Chronic Obstructive/complications/drug 
      therapy/*physiopathology
MH  - *Rest
MH  - Treatment Outcome
EDAT- 2011/09/16 06:00
MHDA- 2012/01/26 06:00
CRDT- 2011/09/16 06:00
PHST- 2011/05/10 00:00 [received]
PHST- 2011/08/22 00:00 [revised]
PHST- 2011/08/24 00:00 [accepted]
PHST- 2011/09/16 06:00 [entrez]
PHST- 2011/09/16 06:00 [pubmed]
PHST- 2012/01/26 06:00 [medline]
AID - S0954-6111(11)00299-X [pii]
AID - 10.1016/j.rmed.2011.08.021 [doi]
PST - ppublish
SO  - Respir Med. 2011 Dec;105(12):1836-45. doi: 10.1016/j.rmed.2011.08.021. Epub 2011 
      Sep 13.