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Combined corticosteroid and long-acting beta2-agonist in one inhaler versus placebo for chronic obstructive pulmonary disease

  1. Luis Javier Nannini1,*,
  2. Phillippa Poole2,
  3. Stephen J Milan3,
  4. Rebecca Holmes3,
  5. Rebecca Normansell3

Editorial Group: Cochrane Airways Group

Published Online: 10 NOV 2013

Assessed as up-to-date: 26 JUN 2013

DOI: 10.1002/14651858.CD003794.pub4


How to Cite

Nannini LJ, Poole P, Milan SJ, Holmes R, Normansell R. Combined corticosteroid and long-acting beta2-agonist in one inhaler versus placebo for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews 2013, Issue 11. Art. No.: CD003794. DOI: 10.1002/14651858.CD003794.pub4.

Author Information

  1. 1

    Hospital E Peron, Pulmonary Section, G. Baigorria, Santa Fe - Rosario, Argentina

  2. 2

    University of Auckland, Department of Medicine, Auckland, New Zealand

  3. 3

    St George's, University of London, Population Health Sciences and Education, London, UK

*Luis Javier Nannini, Pulmonary Section, Hospital E Peron, Ruta 11 Y Jm Estrada, G. Baigorria, Santa Fe - Rosario, 2152, Argentina. nanninilj@circulomedicorosario.org.

Publication History

  1. Publication Status: New search for studies and content updated (conclusions changed)
  2. Published Online: 10 NOV 2013

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Barnes 2006 {published and unpublished data}
  • Barnes NC, Qiu Y, Pavord I, Parker D, Johnson M, Thompson M, et al. Salmeterol/fluticasone propionate (SFC) anti-inflammatory effects in COPD [Abstract]. American Thoracic Society 2005 International Conference; May 20-25; San Diego. 2005:B93 [Poster 320].
  • Barnes NC, Qiu Y-S, Pavord ID, Parker D, Davis PA, Zhu J, et al. Antiinflammatory effects of salmeterol/fluticasone propionate in chronic obstructive lung disease. American Journal of Respiratory & Critical Care Medicine 2006;173(7):736-43.
  • Qiu Y, Parker D, Barnes NC, Johnson M, Pavord L, et al. The effect of salmeterol/fluticasone propionate (SFC) on eosinophils and mast cells in COPD [Abstract]. American Thoracic Society 2005 International Conference; May 20-25; San Diego. 2005:A43 [Poster F36].
  • Qiu YS, Davis P, Zhu J, Peachey L, Barnes NC, Pavord I, et al. Anti-inflammatory effects of salmeterol/fluticasone propionate (SFC) on airway T-lymphocyte populations in COPD. European Respiratory Journal 2005;26 Suppl 49:203s.
  • Qiu YS, Davis P, Zhu J, Peachey L, Barnes NC, Pavord I, et al. Effects of salmeterol/fluticasone propionate (SFC) on airway inflammation in COPD: a placebo-controlled study of endobronchial biopsies. European Respiratory Journal 2005;26 Suppl 49:203s.
  • SCO30005. A 13-week, double-blind, parallel-group, multicentre study to compare the bronchial anti-inflammatory activity of the combination of salmeterol/fluticasone propionate (SERETIDE™/ADVAIR™/VIANI™) 50/500 mcg twice daily compared with placebo twice daily in patients with chronic obstructive pulmonary disease. http://www.gsk-clinicalstudyregister.com/quick-search-list.jsp?tab=results&letterrange=All&type=GSK+Study+ID&item=SCO30005&studyType=All&phase=All&status=All&population=All&marketing=All&country=All&studyId=SCO30005 (accessed 10 June 2013).
  • Zhu J, Qiu Y, Barnes NC, Johnson M, Pavord I, Jeffery PK. The effect of salmeterol/fluticasone propionate (SFC) on pro-inflammatory gene expression in COPD [Abstract]. American Thoracic Society 2005 International Conference; May 20-25; San Diego. 2005:A43 [Poster F6].
Bourbeau 2007 {published data only}
  • Bourbeau J, Christodoulopoulos P, Maltais F, Yamauchi Y, Olivenstein R, Hamid Q. Effect of salmeterol/fluticasone propionate on airway inflammation in COPD: a randomised controlled trial. Thorax 2007; Vol. 62, issue 11:938-43.
Calverley 2003 {published and unpublished data}
  • AstraZeneca SD. A placebo-controlled 12-month efficacy study of the fixed combination budesonide/formoterol compared to budesonide and formoterol as monotherapies in patients with chronic obstructive pulmonary disease (COPD). http://www.astrazenecaclinicaltrials.com/drug-products/drugproducts/?itemId=8574657 (accessed 8 June 2013).
  • Borgstrom L, Asking L, Olsson H, Peterson S. Lack of interaction between disease severity and therapeutic response with budesonide/formoterol in a single inhaler [Abstract]. American Thoracic Society 100th International Conference; May 21-26; Orlando. 2004:C22 [Poster 505].
  • Calverley PM, Bonsawat W, Cseke Z, Zhong N, Peterson S, Olsson H. Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease. European Respiratory Journal 2003;22(6):912-9.
  • Calverley PM, Szafranski W, Andersson, Calverley PMA, Andersson A. Budesonide/formoterol is a well-tolerated long term maintenance therapy for COPD [Abstract]. European Respiratory Journal 2005; Vol. 26 Suppl 49:Abstract No. 1917.
  • Calverley PMA, Cseke Z, Peterson S. Budesonide/formoterol reduces the use of oral corticosteroids in the treatment of COPD [Abstract]. European Respiratory Journal 2003;22 Suppl 45:P436.
  • Calverley PMA, Kuna P, Olsson H. COPD exacerbations are reduced by budesonide/formoterol in a single inhaler [Abstract]. European Respiratory Journal 2003;22 Suppl 45:P1587.
  • Calverley PMA, Olsson H, Symbicort International COPD Study Group. Budesonide/formoterol ina single inhaler sustains improvements in lung function over 12 months compared with monocomponents and placebo in patients with COPD [abstract]. American Thoracic Society 99th International Conference; May 16-12; Seattle. 2003:B024 [Poster 418].
  • Calverley PMA, Peterson S. Combining budesonide/formoterol in a single inhale reduces exacerbation frequency in COPD [abstract]. American Thoracic Society 99th International Conference; May 16-21; Seattle. 2003:D092 [Poster 211].
  • Calverley PMA, Stahl E, Jones PW. Budesonide/formoterol improves the general health status of patients with COPD [Abstract]. American Thoracic Society 2005 International Conference; May 20-25; San Diego. 2005:B93 [Poster 303].
  • Calverley PMA, Szafranski W, Andersson A. Budesonide/formoterol is a well-tolerated long term maintenance therapy for COPD. European Respiratory Journal 2005;26 Suppl 49:Poster 1917.
  • Calverley PMA, Thompson NC, Olsson H. Budesonide/formoterol in a single inhaler sustains lung function improvements in COPD [Abstract]. European Respiratory Journal 2003;22 Suppl 45:P435.
  • Halpin D, Stahl E, Lundback B, Anderson F, Peterson S. Treatment costs and number needed to treat (NNT) with budesonide/formoterol to avoid one exacerbation of COPD [Abstract]. American Thoracic Society 100th International Conference; May 21-26; Orlando. 2004:D22 [Poster 525].
  • Halpin DMG, Larsson T, Calverley PMA. How many patients with COPD must be treated with budesonide/formoterol compared with formoterol alone to avoid 1 day of oral steroid use? [Abstract]. American Thoracic Society 2005 International Conference; May 20-25; San Diego. 2005:B93 [Poster 314].
  • Jones PW, Stahl E. Budesonide/formoterol in a single inhaler improves health status in patients with COPD [abstract]. American Thoracic Society 99th International Conference; May 16-21; Seattle. 2003:B024 [Poster 419].
  • Jones PW, Ståhl E. Reducing exacerbations leads to a better health-related quality of life in patients with COPD. 13th ERS Annual Congress; 27 September; Vienna. 2003:P1586.
  • Jones PW, Ståhl E. Budesonide/formoterol sustains clinically relevant improvements in health status in COPD [Abstract]. European Respiratory Journal 2005;26 Suppl 49:Abstract 1352.
  • Lofdahl CG. Reducing the impact of COPD exacerbations: clinical efficacy of budesonide/formoterol. European Respiratory Review 2004;13(88):14-21.
  • Lofdahl CG, Andreasson E, Svensson K, Ericsson A. Budesonide/formoterol in a single inhaler improves health status in patients with COPD without increasing healthcare costs [Abstract]. European Respiratory Journal 2003;22 Suppl 45:P433.
  • Lofdahl CG, Ericsson A, Svensson K, Andreasson E. Cost effectiveness of budesonide/formoterol in a single inhaler for COPD compared with each monocomponent used alone. Pharmacoeconomics 2005;23(4):365-75.
Dal Negro 2003 {published data only}
  • Dal Negro R, Micheletto C, Trevsian F, Tognella S. [A98] Salmeterol and fluticasone 50ug/250ug BiD versus salmeterol 50ug bid and versus placebo in the long term treatment of COPD. Proceedings of the 98th International American Thoracic Society Conference; May 17-22; Atlanta. 2002.
  • Dal Negro RW, Pomari C, Tognella S, Micheletto C. Salmeterol & fluticasone 50 microg/250 microg bid in combination provides a better long-term control than salmeterol 50 microg bid alone and placebo in COPD patients already treated with theophylline. Pulmonary Pharmacology and Therapeutics 2003;16(4):241-6.
Doherty 2012 {published data only}
  • Doherty DE, Kerwin E, Tashkin DP, Matiz-Bueno CE, Shekar T, Banerjee S, et al. Combined mometasone furoate and formoterol in patients with moderate to very severe chronic obstructive pulmonary disease (COPD): phase 3 efficacy and safety study [Abstract]. Journal of Allergy and Clinical Immunology 2012; Vol. 129, issue 2 Suppl:AB75 [283].
  • Doherty DE, Tashkin DP, Kerwin E, Knorr BA, Shekar T, Banerjee S, et al. Effects of mometasone furoate/formoterol fumarate fixed-dose combination formulation on chronic obstructive pulmonary disease (COPD): results from a 52-week Phase III trial in subjects with moderate-to-very severe COPD. International Journal of Chronic Obstructive Pulmonary Disease 2012; Vol. 7:57-71.
  • NCT00383721. A randomized, 26-week, placebo-controlled efficacy and safety study with a 26-week long-term safety extension, of high- and medium-dose inhaled mometasone furoate/formoterol fixed-dose combination formulation compared with formoterol and high-dose inhaled mometasone furoate monotherapy in subjects with moderate to severe COPD. http://clinicaltrials.gov/show/NCT00383721 (accessed 10 June 2013). [CRS-ID: 4900100000059605]
Hanania 2003 {published and unpublished data}
  • Hanania NA, Darken P, Horstman D, Reisner C, Lee B, Davis S, et al. The efficacy and safety of fluticasone propionate (250 micro g)/salmeterol (50 micro g) combined in the diskus inhaler for the treatment of COPD. Chest 2003;124(3):834-43.
  • Hanania NA, Ramsdell J, Payne K, Davis S, Horstman D, Lee B, et al. Improvements in airflow and dyspnea in COPD patients following 24 weeks treatment with salmeterol 50mcg and fluticasone propionate 250mcg alone or in combination via the diskus. American Journal of Respiratory & Critical Care Medicine 2001;163(5 Suppl):A279.
  • Horstman D, Darken P, Davis S, Lee B. Improvements in FEV1 and symptoms in poorly reversible COPD patients following treatment with salmeterol 50mcg/fluticasone propionate 250mcg combination [Abstract]. European Respiratory Journal 2003;22 Suppl 45:P434.
  • Mahler DA, Darken P, Brown CP, Knobil K. Predicting lung function responses to combination therapy in chronic obstructive pulmonary disease (COPD) [Abstract]. National COPD Conference November 14-15, Arlington, Virginia. 2003:Abstract 1081.
  • Mahler DA, Darken P, Brown CP, Knobil K. Predicting lung function responses to salmeterol/fluticasone propionate combination therapy in COPD [Abstract]. European Respiratory Journal 2003;22 Suppl 45:P429.
  • SFCA3007. A randomized, double-blind, placebo-controlled, parallel-group trial evaluating the safety and efficacy of the DISKUS formulations of Salmeterol (SAL) 50mcg BID and Fluticasone Propionate (FP) 250mcg BID individually and in combination as Salmeterol 50mcg/Fluticasone Propionate 250mcg BID (SFC 50/250) compared to placebo in COPD subjects. . http://www.gsk-clinicalstudyregister.com/result_detail.jsp?protocolId=SFCA3007&studyId=0A633AAD-F2BD-4DA0-B6A4-19A812646565&compound=SFCA3007&type=GSK+Study+ID&letterrange=All (accessed 10 June 2013).
  • Spencer M, Wire P, Lee B, Chang CN, Darken P, Horstman D. Patients with COPD using salmeterol/fluticasone propionate combination therapy experience improved quality of life. European Respiratory Journal 2003;22 Suppl 45:51s.
  • Spencer MD, Karia N, Anderson J. The clinical significance of treatment benefits with the salmeterol/fluticasone propionate 50/500mcg combination in COPD. European Respiratory Journal 2004;24 Suppl 48:290s.
Lapperre 2009 {published data only}
  • Lapperre TS, Snoeck-Stroband JB, Gosman MM, Jansen DF, van Schadewijk A, Thiadens HA, et al. Effect of fluticasone with and without salmeterol on pulmonary outcomes in chronic obstructive pulmonary disease: a randomized trial. Annals of Internal Medicine 2009; Vol. 151, issue 8:517-27.
Mahler 2002 {published and unpublished data}
  • Mahler DA, Darken P, Brown CP, Knobil K. Predicting lung function responses to combination therapy in chronic obstructive pulmonary disease (COPD). http://www.abstracts2view.com (accessed 1 April 2004).
  • Mahler DA, Wire P, Horstman D, Chang CN, Yates J, Fischer T, et al. Effectiveness of fluticasone propionate and salmeterol combination delivered via the diskus device in the treatment of chronic obstructive pulmonary disease. American Journal of Respiratory Critical Care Medicine 2002;166(8):1084-91.
  • SFCA3006. A randomized, double-blind, placebo-controlled, parallel-group trial evaluating the safety and efficacy of the DISKUS formulations of Salmeterol (SAL) 50mcg BID and Fluticasone Propionate (FP) 500mcg BID individually and in combination as Salmeterol 50mcg/Fluticasone Propionate 500mcg BID (SFC 50/500) compared to placebo in COPD subjects. http://www.gsk-clinicalstudyregister.com/result_detail.jsp?protocolId=SFCA3006&studyId=ECBB8395-5CCB-410C-91DA-1420726FB071&compound=fluticasone+propionate%2Fsalmeterol&type=Compound&letterrange=A-F (accessed 8 June 2013).
  • Spencer M, Wire P, Lee B, Chang CN, Darken P, Horstman D. Patients with COPD using salmeterol/fluticasone propionate combination therapy experience improved quality of life. European Respiratory Journal 2003;22 Suppl 45:51s.
  • Spencer MD, Anderson JA. Salmeterol/fluticasone combination produces clinically important benefits in dyspnea and fatigue [Abstract]. American Thoracic Society 2005 International Conference; May 20-25; San Diego. 2005.
  • Spencer MD, Karia N, Anderson J. The clinical significance of treatment benefits with the salmeterol/fluticasone propionate 50/500mcg combination in COPD. European Respiratory Journal 2004;24 Suppl 48:290s.
O'Donnell 2006 {published and unpublished data}
  • Celli B, Emmett A, Crater G, Kalberg C. Salmeterol/fluticasone propionate (SFC) improves the inspiratory to total lung capacity ratio (IC/TLC) and exercise endurance time in patients with COPD. European Respiratory Journal 2006;28(Suppl 50):764s.
  • Make B, Emmett A, Crater G, O'Dell D, Kalberg C. Improvement in exercise endurance time (EET) with fluticasone propionate/salmeterol correlations with spirometry and plethysmography. Proceedings of the American Thoracic Society; May 19-24; San Diego. 2006.
  • O'Donnell DE, Sciurba F, Celli B, Mahler DA, Webb KA, Kalberg CJ, et al. Effect of fluticasone propionate/salmeterol on lung hyperinflation and exercise endurance in COPD. Chest 2006;130(3):647-56.
  • SCO40030. A randomized, double-blind, placebo-controlled, parallel group clinical trial evaluating the effect of the fluticasone propionate/salmeterol combination product 250/50mcg bid via DISKUS and salmeterol 50mcg bid via DISKUS on lung hyperinflation in subjects with chronic obstructive pulmonary disease (COPD). http://www.gsk-clinicalstudyregister.com/result_detail.jsp?protocolId=SCO40030&studyId=8CE29C37-5F7D-4461-B1A6-1A1FDA5981A6&compound=SCO40030&type=GSK+Study+ID&letterrange=All (accessed 10 June 2013).
Rennard 2009 {published data only}
  • A 12-month double-blind, double-dummy, randomized, parallel group, multicenter efficacy & safety study of SYMBICORT® pMDI 2 × 160/4.5 mcg bid and 2 × 80/4.5mcg bid compared to formoterol TBH 2 × 4.5 mcg bid and placebo in patients with COPD. http://www.astrazenecaclinicaltrials.com/therapy-areas/respiratory-inflammation/?itemId=8574296 (accessed 8 June 2013).
  • Laties A, Rennard SI, Tashkin DP, Suchower LJ, Martin UJ. Effect of budesonide/formoterol pressurized metered-dose inhaler (bud/fm pmdi) on ophthalmologic assessments in moderate to very severe chronic obstructive pulmonary disease (COPD) patients: results from a 1-year, randomized, controlled clinical trial [Abstract]. Chest 2010; Vol. 138, issue 4:468A.
  • NCT00206167. A 12-month double-blind, double-dummy, randomized, parallel group, multicenter efficacy and safety study of Symbicort® pMDI 2 × 160/4.5 μg Bid and 2 × 80/4.5 μg Bid compared to Formoterol Turbuhaler® 2 × 4.5 μg Bid and placebo in patients with COPD. http://clinicaltrials.gov/show/NCT00206167 (accessed 8 June 2013). [CRS-ID: 4900100000059639]
  • Rennard SI, Tashkin DP, McElhattan J, Goldman M, Ramachandran S, Martin UJ, et al. Efficacy and tolerability of budesonide/formoterol in one hydrofluoroalkane pressurized metered-dose inhaler in patients with chronic obstructive pulmonary disease: results from a 1-year randomized controlled clinical trial. Drugs. Adis Data Information BV., 2009; Vol. 69, issue 5:549-65.
  • Rennard SI, Tashkin DP, McElhattan J, Goldman M, Silkoff PE. Long-term tolerability of budesonide and formoterol administered in one pressurized metered-dose inhaler in patients with moderate to very severe chronic obstructive pulmonary disease [Abstract]. Chest 2008; Vol. 134, issue 4_MeetingAbstracts:p103001.
  • Rennard SI, Tashkin DP, Suchower LJ, Martin UJ. Effect of budesonide/formoterol pressurized metered-dose inhaler (BUD/FM pMDI) on bone mineral density (BMD) in moderate to very severe chronic obstructive pulmonary disease (COPD) patients: results from a 1-year, randomized, controlled clinical trial [Abstract]. Chest 2010; Vol. 138, issue 4:863A.
SCO104925 {published data only}
  • Evaluation of novel endpoints in subjects with chronic obstructive pulmonary disease (COPD) in a randomized, double-blind, placebo-controlled study of treatment with fluticasone propionate/salmeterol 500/50mcg combination and its individual components, fluticasone propionate 500mcg and salmeterol 50mcg. http://www.gsk-clinicalstudyregister.com/quick-search-list.jsp?item=SCO104925&type=GSK+Study+ID& studyId=SCO104925 (accessed 8 June 2013).
SFCT01 {unpublished data only}
  • SCO30002. A multicentre, randomised, double-blind, parallel group, placebo-controlled study to compare the efficacy and safety of inhaled salmeterol/fluticasone propionate combination product 25/250 µg two puffs bd and fluticasone propionate 250µg two puffs bd alone, all administered via metered dose inhalers (MDI), in the treatment of subjects with chronic obstructive pulmonary disease (COPD) for 52 weeks. http://www.gsk-clinicalstudyregister.com/quick-search-list.jsp?item=SCO30002&type=GSK+Study+ID&studyId=SCO30002 (accessed 10 June 2013).
Sin 2008 {published data only}
  • NCT00120978. Advair - CRP study. http://clinicaltrials.gov/show/NCT00120978 (accessed 10 June 2013). [CRS-ID: 4900100000059673]
  • Sin DD, Man SF, Marciniuk DD, Ford G, FitzGerald M, Wong E, et al. ABC (Advair, Biomarkers in COPD) Investigators. Can inhaled fluticasone alone or in combination with salmeterol reduce systemic inflammation in chronic obstructive pulmonary disease? Study protocol for a randomized controlled trial [NCT00120978]. BMC Pulmonary Medicine 2006;6(3):3.
  • Sin DD, Man SF, Marciniuk DD, Ford G, FitzGerald M, Wong E, et al. The effects of fluticasone with or without salmeterol on systemic biomarkers of inflammation in chronic obstructive pulmonary disease [see comment]. American Journal of Respiratory and Critical Care Medicine 2008; Vol. 177, issue 11:1207-14.
Szafranski 2003 {published and unpublished data}
  • Anderson P. Budesonide/formoterol in a single inhaler (Symbicort) provides early and sustained improvement in lung function in moderate to severe COPD [Abstract]. Thorax 2002;57(Suppl III):iii43.
  • AstraZeneca SD. A placebo-controlled 12 month efficacy study of the fixed combination budesonide/formoterol compared with budesonide and formoterol as monotherapies in patients with chronic obstructive pulmonary disease (COPD). http://www.astrazenecaclinicaltrials.com/diseases-and-conditions/diseaseandconditions/?itemId=8574657 (accessed 9 June 2013).
  • Borgstrom L, Asking L, Olsson H, Peterson S. Lack of interaction between disease severity and therapeutic response with budesonide/formoterol in a single inhaler [Abstract]. American Thoracic Society 100th International Conference; May 21-26; Orlando. 2004:C22 [Poster 505].
  • Calverley P, Pauwels R, Lofdahl CG, Svensson K, Higenbottam T, et al. Relationship between respiratory symptoms and medical treatment in exacerbations of COPD. European Respiratory Journal 2005;26(3):406-13.
  • Calverley PMA. Effect of budesonide/formoterol on severe exacerbations and lung function in moderate to severe COPD. BTS Winter Meeting; London. December 2002:S145.
  • Calverley PMA, Szafranski W, Andersson A. Budesonide/formoterol is a well-tolerated long term maintenance therapy for COPD. European Respiratory Journal 2005;26 Suppl 49:Poster 1917.
  • Calverley PMA, Thompson NC, Olsson H. Budesonide/formoterol in a single inhaler sustains lung function improvements in COPD [Abstract]. European Respiratory Journal 2003;22 Suppl 45:P435.
  • Campbell LM, Szafranski W. Budesonide/formoterol in a single inhaler (Symbicort) provides sustained relief from symptoms in moderate to severe COPD. BTS Winter Meeting. London. 2002:S143.
  • Campell LW, Szafranski W. Budesonide/Formoterol in a single inhaler (Symbicort) reduces severe exacerbations in patients with moderate-severe COPD. BTS Winter Meeting. London. 2002:S141.
  • Dahl R, Cukier A, Olsson H. Budesonide/formoterol in a single inhaler reduces severe and mild exacerbations in patients with moderate to severe COPD. European Respiratory Journal 2002;20 Suppl 38:242 [P1575].
  • Egede F, Menga G. Budesonide/formoterol in a single inhaler provides sustained relief from symptoms and night-time awakenings in moderate-severe COPD: results from symptoms and night-time awakenings in moderate to severe COPD: results from a 1-year study. European Respiratory Journal 2002;20 Suppl 38:242 [P1574].
  • Halpin D, Stahl E, Lundback B, Anderson F, Peterson S. Treatment costs and number needed to treat (NNT) with budesonide/formoterol to avoid one exacerbation of COPD [Abstract]. American Thoracic Society 100th International Conference; May 21-26; Orlando. 2004:D22 [Poster 525].
  • Jones PW, Stahl E, Svensson K. Improvement in health status in patients with moderate to severe COPD after treatment with budesonide/formoterol in a single inhaler. European Respiratory Journal 2002;20 Suppl 38:250 [P1613].
  • Korsgaard J, Sansores R. Budesonide/formoterol (single inhaler) provides sustained relief from shortness of breath and chest tightness in a 1-year study of patients with moderate to severe COPD. European Respiratory Journal 2002;20 Suppl 38:242 [P1577].
  • Lange P, Saenz C. Budesonide/formoterol in a single inhaler is well tolerated in patients with moderate to severe COPD: results of a 1 year study. European Respiratory Journal 2002;20 Suppl 38:242 [P1573].
  • Lofdahl CG. Reducing the impact of COPD exacerbations: clinical efficacy of budesonide/formoterol. European Respiratory Review 2004;13(88):14-21.
  • Milanowski J, Nahabedian S. Budesonide/formoterol in a single inhaler acts rapidly to improve lung function and relieve symptoms in patients with moderate to severe COPD. European Respiratory Journal 2002;20 Suppl 38:242 [P1576].
  • Szafranski W, Cukier A, Ramirez A, Menga G, Sansores R, Nahabedian S, et al. Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. European Respiratory Journal 2003;21(1):74-81.
Tashkin 2008 {published data only}
  • Astrazeneca (D5899C00002). A 6-month double-blind, double-dummy, randomized, parallel group, multicenter efficacy & safety study of Symbicort® pMDI 2 × 160/4.5mg & 80/4.5mg bid compared to Formoterol TBH, Budesonide pMDI (& the combination) & placebo in COPD patients. www.astrazenecaclinicaltrials.com (accessed 8 April 2008).
  • Tashkin DP, Rennard SI, Martin P, Goldman M, Silkoff PE. Efficacy of budesonide/formoterol administered via one pressurized metered-dose inhaler over 6 months in patients with chronic obstructive pulmonary disease [Abstract]. Chest 2008; Vol. 134, issue 4:105001s.
  • Tashkin DP, Rennard SI, Martin P, Ramachandran S, Martin UJ, Silkoff PE, et al. Efficacy and safety of budesonide and formoterol in one pressurized metered-dose inhaler in patients with moderate to very severe chronic obstructive pulmonary disease : results of a 6-month randomized clinical trial. Drugs 2008; Vol. 68, issue 14:1975-2000.
Tashkin 2012 {published data only}
  • Kerwin E, Tashkin DP, Matiz-Bueno CE, Doherty DE, Shekar T, Banerjee S, et al. Clinical efficacy and safety of combined mometasone furoate and formoterol in patients with moderate to very severe chronic obstructive pulmonary disease (COPD) [Abstract]. Journal of Allergy and Clinical Immunology 2012; Vol. 129, issue 2 Suppl:AB201 [759].
  • NCT00383435. A randomized, 26-week, placebo-controlled efficacy and safety study with a 26-week long-term safety extension, of high- and medium-dose inhaled mometasone furoate/formoterol fixed-dose combination formulation compared with formoterol and high-dose inhaled mometasone furoate monotherapy in subjects with moderate to severe COPD. http://clinicaltrials.gov/show/NCT00383435 (accessed 9 June 2013). [CRS-ID: 4900100000059603]
  • Tashkin DP, Doherty DE, Kerwin E, Matiz-Bueno CE, Knorr B, Shekar T, et al. Efficacy and safety of a fixed-dose combination of mometasone furoate and formoterol fumarate in subjects with moderate to very severe COPD: results from a 52-week Phase III trial. International Journal of Chronic Obstructive Pulmonary Disease 2012;7:43-55.
TORCH {published and unpublished data}
  • Briggs AH, Glick HA, Lozano-Ortega G, Spencer M, Calverley PM, Jones PW, et al. Is treatment with ICS and LABA cost-effective for COPD? Multinational economic analysis of the TORCH study. European Respiratory Journal 2010;35(3):532-9.
  • Calverley P, Celli B, Anderson JA, Ferguson GT, Jenkins C, Jones PW, et al. The Towards a Revolution in COPD Health (TORCH) study: salmeterol/fluticasone propionate improves survival in COPD over three years. Respirology 2006;11(Suppl 5):A149.
  • Calverley PM, Anderson JA, Celli B, Ferguson GT, Jenkins C, Jones PW, et al. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease.[see comment]. New England Journal of Medicine 2007; Vol. 356, issue 8:775-89.
  • Calverley PM, Celli B, Anderson JA, Ferguson GT, Jenkins C, Jones PW, et al. The towards a revolution in COPD health (TORCH) study: fluticasone propionate /salmeterol improves survival in COPD over three years. Chest 2006;130(4):122s.
  • Calverley PMA, Anderson JA, Celli B, Ferguson GT, Jenkins C, Jones PW, et al. Cardiovascular events in patients with chronic obstructive pulmonary disease: TORCH study results. Thorax 2010;65:719-25.
  • Calverley PMA, Anderson JA, Celli B, Ferguson GT, Jenkins C, Jones PW, et al. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. New England Journal of Medicine 2007;356(8):775-89.
  • Calverley PMA, Celli B, Andersen JA, Ferguson GT, Jenkins C, Jones PW, et al. The TORCH (towards a revolution in COPD health) study salmeterol/fluticasone propionate (SFC) improves survival in COPD over three years. European Respiratory Journal 2006;28(Suppl 50):34s.
  • Calverley PMA, Celli B, Ferguson G, Jenkins C, Jones PW, Pride NB, et al. Baseline characteristics of the first 5,000 COPD patients enrolled in the TORCH survival study. European Respiratory Journal 2003;22 Suppl 45:578s.
  • Celli B, Calverley PM, Anderson JA, Ferguson GT, Jenkins C, Jones P, et al. The TOwards a Revolution in COPD HEalth (TORCH) Study: salmeterol/fluticasone propionate reduces the rate of exacerbations over three years. Respirology 2006;11(Suppl 5):A140.
  • Celli B, Calverley PMA, Anderson JA, Ferguson GT, Jenkins C, Jones PW, et al. The TORCH (TOwards a Revolution in COPD Health) study: salmeterol/fluticasone propionate (SFC) improves health status, reduces exacerbations and improves lung function over three years. European Respiratory Journal 2006;28 Suppl 50:34s.
  • Celli B, Vestbo J, Jenkins CR, Jones PW, Ferguson GT, Calverley PM, et al. Sex differences in mortality and clinical expressions of patients with chronic obstructive pulmonary disease: the TORCH experience. American Journal of Respiratory and Critical Care Medicine 2011;183(3):317-22.
  • Celli BR, Thomas NE, Anderson JA, Ferguson GT, Jenkins CR, Jones PW, et al. Effect of pharmacotherapy on rate of decline of lung function in chronic obstructive pulmonary disease: results from the TORCH study. American Journal of Respiratory and Critical Care Medicine 2008;174(4):332-8.
  • Corhay JL, Louis R. Clinical study of the month: the TORCH study (TOwards a Revolution in COPD Health) [L'étude clinique du mois. L'étude TORCH (TOwards a Revolution in COPD Health): vers une revolution de la santé des patients souffrant de BPCO]. Revue Medicale de Liege 2007;62(4):230-4.
  • Crim C, Calverley PM, Anderson JA, Celli B, Ferguson GT, Jenkins C, et al. Pneumonia risk in COPD patients receiving inhaled corticosteroids alone or in combination: TORCH study results. European Respiratory Journal 2009;34(3):641-7.
  • Ferguson GT, Calverley PM, Anderson JA, Celli B, Jenkins C, Jones PW, et al. The towards a revolution in COPD health (TORCH) study: fluticasone propionate/salmeterol is well tolerated in patients with COPD over 3 years. Chest 2006;130(4):178s.
  • Ferguson GT, Calverley PM, Anderson JA, Jenkins CR, Jones PW, Willits LR, et al. Prevalence and progression of osteoporosis in patients with COPD: results from the TOwards a Revolution in COPD Health study. Chest 2009; Vol. 136, issue 6:1456-65.
  • Ferguson GT, Calverley PMA, Anderson JA, et al. The TORCH (TOwards a Revolution in COPD Health) study: salmeterol/fluticasone propionate (SFC) improves survival in COPD over three years. European Respiratory Journal 2006;28 Suppl 50:34s.
  • Houghton CM, Lawson N, Borrill ZL, Wixon CL, Yoxall S, Langley SJ, et al. Comparison of the effects of salmeterol/fluticasone propionate with fluticasone propionate on airway physiology in adults with mild persistent asthma. Respiratory Research 2007;8:52.
  • Jenkins CR, Calverley PMA, Celli B, Ferguson G, Jones PW, Pride N, et al. Seasonal patterns of exacerbation rates in the TORCH survival study. http://www.abstracts2view.com (accessed 1 April 2007):A839.
  • Jenkins CR, Celli B, Anderson JA, Ferguson GT, Jones PW, Vestbo J, et al. Seasonality and determinants of moderate and severe COPD exacerbations in the TORCH study. European Respiratory Journal 2012;39(1):38-45.
  • Jenkins CR, Jones PW, Calverley PM, Celli B, Anderson JA, Ferguson GT, et al. Efficacy of salmeterol/fluticasone propionate by GOLD stage of chronic obstructive pulmonary disease: analysis from the randomised, placebo-controlled TORCH study. Respiratory Research 2009;10:59.
  • Johnson M, Agusti AG, Barnes NC. Reflections on TORCH: potential mechanisms for the survival benefit of salmeterol/fluticasone propionate in COPD patients. COPD 2008;5(6):369-75.
  • Jones PW, Anderson JA, Calverley PM, Celli BR, Ferguson GT, Jenkins C, et al. Health status in the TORCH study of COPD: treatment efficacy and other determinants of change. Respiratory Research 2011;12:71.
  • Jones PW, Calverley P, Celli B, Ferguson G, Jenkins C, Pride N. Trans-regional validity of the SGRQ in the TORCH survival study. http://www.abstracts2view.com (accessed 1 April 2004):A122.
  • Jones PW, Calverley PM, Celli B, Anderson JA, Ferguson GT, Jenkins C, et al. The towards study a revolution in COPD health (TORCH) study: fluticasone propionate/salmeterol improves and sustains health status in COPD over 3 years. Chest 2006;130(4):177s.
  • McGarvey LP, John M, Anderson JA, Zvarich MT, Wise RA. Ascertainment of cause-specific mortality in COPD: operations of the TORCH Clinical Endpoint Committee. Thorax 2007;62:411-5.
  • NCT00268216. Survival of subjects with chronic obstructive pulmonary disease (COPD). http://clinicaltrials.gov/show/NCT00268216 (accessed 9 July 2013). [CRS-ID: 4900100000059729]
  • SCO30003. A multicentre, randomised, double-blind, parallel group, placebo-controlled study to investigate the long-term effects of salmeterol/fluticasone propionate (SERETIDE®/VIAN/ADVAIR®) 50/500mcg bd, salmeterol 50mcg bd and fluticasone propionate 500mcg bd, all delivered via the DISKUS®/ACCUHALER® inhaler, on the survival of subjects with chronic obstructive pulmonary disease (COPD) over 3 years of treatment, 2006. http://www.gsk-clinicalstudyregister.com/quick-search-list.jsp?tab=results&letterrange=All&type=GSK+Study+ID&item=SCO30003&studyType=All&phase=All&status=All&population=All&marketing=All&country=All&studyId=SCO30003 (accessed 9 July 2013).
  • Vestbo J, Anderson JA, Calverley PM, Celli B, Ferguson GT, Jenkins C, et al. Adherence to inhaled therapy, mortality and hospital admission in COPD.. Thorax 2009;64(11):939-43.
  • Vestbo J, Calverley P, Celli B, Ferguson G, Jenkins C, Jones P, et al. The TORCH (TOwards a Revolution in COPD Health) survival study protocol. European Respiratory Journal 2004;24(2):206-10.
  • Wise RA, McGarvey LP, John M, Anderson JA, Zvarich MT. Reliability of cause-specific mortality adjudication in a COPD clinical trial. http://www.abstracts2view.com (accessed 1 April 2007):A120.
TRISTAN {published and unpublished data}
  • Calverley P, Pauwels R, Vestbo J, Jones P, Pride N, Gulsvik A, et al. Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial. Lancet 2003;361(9356):449-56.
  • Calverley PMA, Pauwels RA, Vestbo J, Jones PW, Pride NB, Gulsvik A, et al. Salmeterol/Fluticasone propionate combination for one year provides greater clinical benefit than its individual components. Proceedings of the 98th International American Thoracic Society Conference; May 17-22; Atlanta. 2002:A98 [Poster 306].
  • Calverley PMA, Pauwels RA, Vestbo J, Jones PW, Pride NB, Gulsvik A, et al. Clinical improvements with salmeterol / fluticasone propionate combination in differing severities of COPD.. American Thoracic Society 99th International Conference; May 16-21; Seattle 2003:A035 [Poster D50].
  • Calverly PMA, Pauwels R, Vestbo J, Jones P, Pride N, Gulsvik A, et al. Safety of salmeterol/fluticasone propionate combination in the treatment of chronic obstructive pulmonary disease. European Respiratory Journal 2002;20 Suppl 38:242 [P1572].
  • Hunjan MK, Chandler F. Numbers needed to treat (NNT) to avoid an exacerbation in patients with chronic obstructive pulmonary disease (COPD) using salmeterol/fluticasone propionate combination (SFC) and associated costs [Abstract]. American Thoracic Society 100th International Conference; May 21-26; Orlando. 2004:D22 [Poster 503].
  • Hunjan MK, Williams DT. Costs of avoiding exacerbations in patients with chronic obstructive pulmonary disease (COPD) treated with salmeterol/ fluticasone propionate combination (seretide) and salmeterol. European Respiratory Journal 2004;24 Suppl 48:291s.
  • Hunjan MK, Williams DT. Salmeterol/ fluticasone propionate combination is clinically effective in avoiding exacerbations in patients with moderate/severe COPD. European Respiratory Journal 2004;24 Suppl 48:513s.
  • Jones PW, Edin HM, Anderson J. Salmeterol/fluticasone propionate combination improves health status in COPD patients. Proceedings of the 98th International American Thoracic Society Conference; May 17-22; Atlanta. 2002:A39 [Poster K39].
  • Jones PW, Ståhl E. Budesonide /formoterol sustains clinically relevant improvements in health status in COPD [Abstract]. European Respiratory Journal 2005;26 Suppl 49:Abstract 1352.
  • Jones PW, Vestbo J, Pauwels RA, Calverley PMA, Anderson JA, Spencer MD. Informative drop out in COPD studies. Investigation of health status of withdrawals in the TRISTAN study. 13th ERS Annual Congress, 27 Spetember, Vienna. 2003:P1593.
  • Morgan M. Salmetrol xinafoate/fluticasone propionate combination product in the treatment of chronic obstructive pulmonary disease. Publication ID: N0123137844 http://www.nihr.ac.uk/Profile/Pages/NRRResults.aspx?publication_id=N0123137844 (accessed 9 July 2013).
  • Nitschmann S. Inhalational combination therapy in chronic obstructive lung disease. Tristan study. German Internist 2004;45(6):727-8.
  • Pauwels R, Vestbo J, Calverley PMA, Jones PW, Pride NB, Gulsvik A. Characterization of exacerbations in the TRISTAN study of salmeterol/fluticasone propionate (SFC) combination in moderate to severe COPD. http://www.abstracts2view.com (accessed 2003).
  • Pauwels RA, Calverly PMA, Vestbo J, Jones PW, Pride N, Gulsvik A, et al. Reduction of exacerbations with salmeterol/fluticasone combination 50/500 mcg bd in the treatment of chronic obstructive pulmonary disease. European Respiratory Journal 2002;20 Suppl 38:240 [P1569].
  • SFCB3024. A multicentre, randomised, double-blind, parallel group, placebo-controlled study to compare the efficacy and safety of the salmeterol/FP combination product at a strength of 50/500mcg bd with salmeterol 50mcg bd alone and FP 500mcg bd alone, delivered via the DISKUS™/ACCUHALER™, in the treatment of subjects with chronic obstructive pulmonary disease (COPD) for 12 months. GlaxoSmithKline Clinical Trials Register http:ctr.gsk.co.uk (accessed 2005).
  • Spencer M, Briggs AH, Grossman RF, Rance L. Development of an economic model to assess the cost effectiveness of treatment interventions for chronic obstructive pulmonary disease. Pharmacoeconomics 2005;23(6):619-37.
  • Spencer MD, Karia N, Anderson J. The clinical significance of treatment benefits with the salmeterol/fluticasone propionate 50/500mcg combination in COPD. European Respiratory Journal 2004;24 Suppl 48:290s.
  • Vestbo J, Calverley PMA, Pauwels R, Jones P, Pride N, Gulsvik A, et al. Absence of gender susceptibility to the combination of salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease. European Respiratory Journal 2002;20 Suppl 38:240 [P1570].
  • Vestbo J, Pauwels R, Anderson JA, Jones P, Calverley P. Early onset of effect of salmeterol and fluticasone propionate in chronic obstructive pulmonary disease. Thorax 2005;60(4):301-4.
  • Vestbo J, Pauwels RS, Calverley PMA, Jones PW, Pride NB, Gulsvik A. Salmeterol / fluticasone propionate combination produces improvement in lung function detectable within 24 Hours in moderate to severe COPD. American Thoracic Society 99th International Conference; May 16-21; Seattle. 2003.
  • Vestbo J, Soriano JB, Anderson JA, Calverley P, Pauwels R, Jones P. Gender does not influence the response to the combination of salmeterol and fluticasone propionate in COPD. Respiratory Medicine 2004;98(11):1045-50.
Zheng 2006 {published data only}
  • SCO100540. A multi-centre, randomised, double-blind, parallel group study to investigate the efficacy and safety of the salmeterol/fluticasone propionate combination at a strength of 50/500µg BD, compared with placebo via Accuhaler™, added to usual chronic obstructive pulmonary disease (COPD) therapy, in subjects with COPD for 24 weeks. http://www.gsk-clinicalstudyregister.com/result_detail.jsp?protocolId=100540&studyId=A8F0EC6F-5ECE-4FA6-9852-FBA8CC004B75&compound=100540&type=GSK+Study+ID&letterrange=All (accessed 9 July 2013).
  • Zheng J, Zhong N, Yang L, Wu Y, Chen P, Wen Z, et al. The efficacy and safety of fluticasone propionate 500 mg/salmeterol 50 mg combined via diskus/accuhaler in Chinese patients with chronic obstructive pulmonary disease (COPD). Chest 2006;130(4):182s.
  • Zhong N, Zheng J, Yang L, Wu Y, Chen P, Wen Z, et al. The efficacy and safety of salmeterol 50µg/fluticasone propionate 500µg combined via accuhaler in Chinese patients with chronic obstructive pulmonary disease [Abstract]. Respirology 2006;11(Suppl 5):A150.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Aaron 2004 {published data only}
  • Aaron SD, Vandemheen K, Ferguson D, FitzGerald M, Maltais F, Boureau J, et al. The Canadian optimal therapy of COPD trial: Design, organization and patient recruitment. Canadian Respiratory Journal 2004;11(8):581-5.
Aaron 2007 {published data only}
  • Aaron SD, Vandemheen KL, Fergusson D, Maltais F, Bourbeau J, Goldstein R, et al. Tiotropium in combination with placebo, salmeterol, or fluticasone-salmeterol for treatment of chronic obstructive pulmonary disease: a randomized trial.[see comment][summary for patients in Ann Intern Med. 2007 Apr 17;146(8):I12; PMID: 17310044]. Annals of Internal Medicine 2007; Vol. 146, issue 8:545-55.
  • Kaplan A. Effects of tiotropium combined with either salmeterol or salmeterol/fluticasone in moderate to severe COPD. Primary Care Respiratory Journal 2007;16(4):258-60.
Bathoorn 2008 {published data only}
  • Bathoorn E, Liesker JJ, Postma DS, Boorsma M, Bondesson E, Koëter GH, et al. Anti-inflammatory effects of combined budesonide/formoterol in COPD exacerbations. COPD 2008; Vol. 5, issue 5:282-90.
Bleecker 2011 {published data only}
  • Bleecker ER, Meyers DA, Bailey WC, Sims AM, Bujac SR, Goldman M, et al. Effect of β2-adrenergic receptor gene polymorphism Gly16Arg on response to budesonide/formoterol pressurized metered-dose inhaler in chronic obstructive pulmonary disease [Abstract]. American Journal of Respiratory and Critical Care Medicine 2011;183(Meeting Abstracts):A4086.
Borgstrom 2003 {published data only}
  • Borgstrom L, Lipniunas P. Budesonide/formoterol in Turbuhaler® is not affected by storage in hot and humid conditions. A clinical pharmacokinetic comparison with fluticasone in Diskus™ [Abstract]. European Respiratory Journal 2003;22 Suppl 45:P1580.
Cazzola 2000 {published data only}
Cazzola 2002a {unpublished data only}
  • Cazzola M, Santus P, Di Marco F, Boveri B, Castagna F, Carlucci P. Bronchodilator effect of an inhaled combination therapy with salmeterol + fluticasone and formoterol + budesonide in patients with COPD. European Respiratory Journal 2002;20 Suppl 38:386 [P2396].
Cazzola 2003 {published data only}
  • Cazzola M, Salzillo A, De Giglio C, Noschee P, D'Amato G. Formoterol/budesonide (FBC) in the treatment of acute exacerbation of COPD [Abstract]. European Respiratory Journal 2003;22 Suppl 45:P1859.
Cazzola 2004 {published data only}
  • Cazzola M, Noschese P, Centanni S, Santus P, Di Marco F, Spicuzza L, et al. Salmeterol/fluticasone propionate in a single inhaler device versus theophylline + fluticasone propionate in patients with COPD. Pulmonary Pharmacology and Therapeutics 2004;17(3):141-5.
  • Cazzola M, Noschese P, D'Amato G, Santus P, Centanni S. Salmeterol/fluticasone propionate in a single inhaler device (SLM/FP) versus theophyline (THEO) + FP in patients with COPD. European Respiratory Journal 2002;20 Suppl 38:386 [P2393].
Cazzola 2004b {published data only}
  • Cazzola M, Santus P, Di Marco F, Carlucci P, Belloni E, Mondoni M, et al. Onset of action of budesonide/formoterol in single inhaler vs. formoterol in patients with COPD [abstract]. American Thoracic Society 99th International Conference; May 16-21; Seattle. 2003:B024 [Poster 410].
  • Cazzola M, Santus P, Di Marco F, Carlucci P, Mondoni M, Matera MG, et al. Onset of action of formoterol/budesonide in single inhaler vs. formoterol in patients with COPD. Pulmonary Pharmacology and Therapeutics 2004;17(3):121-5.
Chapman 2002 {published data only}
  • Chapman KR. Seretide for obstructive lung disease. Expert Opinion on Pharmacotherapy 2002;3(3):341-50.
Cukier 2007 {published data only}
  • Cukier A, Ferreira CAS, Stelmach R, Ribeiro M, Cortopassi F, Calverley PMA. The effect of bronchodilators and oxygen alone and in combination on self-paced exercise performance in stable COPD. Respiratory Medicine 2007;101(4):743-53.
De Backer 2011 {published data only}
  • De Backer L, De Backer J, Vos W, Van Holsbeke C, Vinchurkar S, De Backer W. Double blind, placebo controlled crossover study in COPD patients to assess the acute effect of budesonide/formoterol using HRCT and lung function tests [Abstract]. European Respiratory Society Annual Congress; September 24-28; Amsterdam. 2011; Vol. 38, issue 55:600s [P3362].
Donohue 2004 {published data only}
  • Donohue JF, Kalberg C, Emmett A, Merchant K, Knobil K. A short-term comparison of fluticasone propionate/salmeterol with ipratropium bromide/albuterol for the treatment of COPD. Treatments in Respiratory Medicine 2004;3(3):173-81.
  • Donohue JF, Kalberg C, Emmett A, Merchant K, Knobil K. Fluticasone/salmeterol combination (250/50) provides greater improvement in lung function and symptoms than the combination of ipratropium/albuterol in patients with COPD. Chest 2003;124(4):128S.
  • Kalberg C, Emmett A, Bourne E, Merchant K, Knobil K. Fluticasone propionate/salmeterol provides greater relief of dyspnea than ipratropium/albuterol in patients with COPD [Abstract]. American Thoracic Society 100th International Conference, May 21-26; Orlando. 2004:C22 [Poster 528].
  • Knobil K, Kalberg C, Merchant K, Emmett A, Cicale M. Maintenance of bronchodilator response for advair diskus 250/50 (fluticasone propionate/salmeterol) but not ipratropium/albuterol in patients with COPD [Abstract]. Chest 2004;126(4):807S.
  • Knobil K, Merchant K, Kalberg C, Emmett A, Cicale M. A comparison of patient perceived improvement in symptoms after initiating therapy with either advair diskus (fluticasone propionate/salmeterol) 250/50 or ipratropium/albuterol [Abstract]. Chest 2004;126(4 Suppl):806S-b - 807S-b.
  • Merchant K, Bourne E, Emmett A, Knobil K, Kalberg C. Greater improvement in dyspnea with fluticasone propionate/salmeterol 250/50 compared with salmeterol or ipratropium in patients with COPD [Abstract]. American Thoracic Society 100th International Conference; May 21-26; Orlando. 2004:C22 [Poster 526].
  • Sciurba FC, Kalberg C, Emmett A, Merchant K, Brown C, Knobil K. Efficacy of advair diskus 250/50 (fluticasone propionate/salmeterol) or ipratropium/albuterol in patients with COPD associated with chronic bronchitis and/or emphysema [Abstract]. Chest 2004;126(4 Suppl):807S-a - 808S-a.
Ferguson 2006 {published data only}
  • Ferguson GT. Cardiovascular safety of simultaneous therapy with advair and combivent in the treatment of COPD [Abstract]. Proceedings of the American Thoracic Society; May 19-24; San Diego. 2006:A109 [Poster J2].
GlaxoSmithKline 2004 {published data only}
  • GlaxoSmithKline SAS. A Randomised, Double-Blind, Double-Dummy, Parallel-Group Comparison of SERETIDE DISKUS/ACCUHALER (50/100µg Strength) twice daily (bid) with Budesonide 400µg bid in Adolescents and Adults with Reversible Airways Obstruction. GlaxoSmithKline Clinical Trial Register 2004.
GlaxoSmithKline 2004a {published data only}
  • GlaxoSmithKline SAS. A Randomised, Double-Blind, Double-Dummy, Parallel-Group Comparison of Seretide DISKUS/ACCUHALER (50/250ìg Strength) b.i.d. with Budesonide 800ìg b.i.d. in Adolescents and Adults with Reversible Airways Obstruction. GlaxoSmithKline Clinical Trial Register 2004.
Golabi 2006 {published data only}
  • Golabi P, Topaloglu N, Karakurt S, Celikel T. Effects of tiotropium and salmeterol/fluticasone combination on lung hyperinflation dyspnea and exercise tolerance in COPD [Abstract]. European Respiratory Journal 2006;28(Suppl 50):33s.
Haque 2006 {published data only}
  • Haque RA, Torrego A, Essilfie-Quaye S, Kharitonov SA, Johnson M, Adcock IM, et al. Effect of salmeterol and fluticasone on glucocorticoid receptor translocation in sputum macrophages and peripheral blood mononuclear cells from patients with chronic obstructive pulmonary disease. Proceedings of the American Thoracic Society; May 19-24; San Diego. 2006:A848.
INSPIRE {published data only}
  • GlaxoSmithKline (SCO40036). Multicentre, randomised, double-blind, double-dummy, parallel group, 104-week study to compare the effect of the salmeterol/fluticasone propionate combination product (SERETIDE*) 50/500mcg delivered twice daily via the DISKUS*/ACCUHALER* inhaler with tiotropium bromide 18 mcg delivered once daily via the HandiHaler inhalation device on the rate of health care utilisation exacerbations in subjects with severe chronic obstructive pulmonary disease (COPD). http://ctr.gsk.co.uk (accessed 8 April 2008).
  • Seemungal T, Stockley R, Calverley P, Hagan G, Wedzicha JA. Investigating new standards for prophylaxis in reduction of exacerbations - The INSPIRE study methodology. Journal of Chronic Obstructive Pulmonary Disease 2007;4(3):177-83.
  • Wedzicha J, Stockley R, Seemungal T, Hagan G, Calverley P. The INSPIRE study: effect of salmeterol/fluticasone propionate versus tiotropium bromide on COPD exacerbations. Respirology 2007;12(Suppl 4):A112.
Jiang 2011 {published data only}
  • Jiang YP, Zhao YF, Yang Y. Effect of seretide on quality of life in COPD: Measured with COPD assessment test [Abstract]. Respirology (Carlton, Vic.) 2011;16(Suppl 2):100 [344].
Jung 2012 {published data only}
  • Jung KS, Park HY, Park SY, Kim SK, Kim YK, Shim JJ, et al. Comparison of tiotropium plus fluticasone propionate/salmeterol with tiotropium in COPD: a randomized controlled study. Respiratory Medicine 2012; Vol. 106, issue 3:382-9.
Kardos 2007 {published and unpublished data}
  • Kardos P, Wencker M. Combination therapy with salmeterol and fluticasone propionate (SFC) is more effective than salmeterol (SAL) alone in reducing exacerbations of COPD [Abstract]. European Respiratory Journal 2005;26 Suppl 49:Abstract 1944.
  • Kardos P, Wencker M, Glaab T, Vogelmeier C. Impact of salmeterol/fluticasone propionate versus salmeterol on exacerbations in severe chronic obstructive pulmonary disease. American Journal of Respiratory & Critical Care Medicine 2007;175(2):144-9.
  • SCO30006. A randomised, double-blind, parallel-group study to investigate the protective effect of the combination of fluticasone and salmeterol (500/50µg bid via the DISKUS) compared with salmeterol (50µg bid via the DISKUS) on the incidence of moderate to severe exacerbations in patients with severe chronic obstructive pulmonary disease (COPD) (GOLD III/IV). http://www.gsk-clinicalstudyregister.com/result_detail.jsp?protocolId=SCO30006&studyId=AA5CBD03-AE61-4A49-B915-3A47C25E9C31&compound=SCO30006&type=GSK+Study+ID&letterrange=All (accessed 10 June 2013).
  • Vogelmeier C. Combination therapy with salmeterol and fluticasone propionate (SFC) improves quality of life (QoL) more than salmeterol (SAL) alone in COPD. 42nd Nordic Lung Conference Trondheim 2005;Suppl 22:13.
Lindberg 2007 {published data only}
Lindenberg 2006 {published data only}
  • Lindenberg A, Szalai Z, Pullertis T, Radeczky E, Lindberg A. Budesonide/formoterol (B/F) has an onset of action that is similar to salbutamol and faster than salmeterol/fluticasone in patients with COPD [Abstract]. European Respiratory Journal 2006;28(Suppl 50):214s [P1273].
Mittmann 2010 {published data only}
  • Mittmann N, Hernandez P, Mellstram C, Brannman L, Welte T, Mellström C, et al. Cost-effectiveness of budesonide/formoterol added to tiotropium in COPD patients in Canada, Australia and Sweden [Abstract].. European Respiratory Society Annual Congress; September 18-22; Barcelona. 2010:[5183].
Mittmann 2011 {published data only}
  • Mittmann N, Hernandez P, Mellstrom C, Brannman L, Welte T. Cost effectiveness of budesonide/formoterol added to tiotropium bromide versus placebo added to tiotropium bromide in patients with chronic obstructive pulmonary disease: Australian, Canadian and Swedish healthcare perspectives. PharmacoEconomics 2011; Vol. 29, issue 5:403-14.
NCT00144911 {published data only}
  • NCT00144911. See Detailed Description. http://clinicaltrials.gov/show/NCT00144911 (accessed 9 July 2013). [CRS-ID: 4900100000059685]
NCT00269126 {published data only}
  • NCT00269126. See Detailed Description. http://clinicaltrials.gov/show/NCT00269126 (accessed 9 July 2013). [CRS-ID: 4900100000059651]
NCT00476099 {published data only}
  • NCT00476099. A 48-Week, Double Blind, Double Dummy, Randomised, Multinational, Multicentre, 3-Arm Parallel Group Clinical Study of "Fixed Combination" Beclometasone Dipropionate Plus Formoterol Fumarate Administered Via pMDI With HFA-134a Propellant Versus "Fixed Combination" Budesonide Plus Formoterol DPI Versus Formoterol DPI in Patients With Stable Severe Chronic Obstructive Pulmonary Disease (COPD). Http://clinicaltrials.gov/show/NCT00476099 (accessed 9 July 2013). [CRS-ID: 4900100000059631]
Noschese 2003 {published data only}
  • Noschese P, De Michele F, D'Amato G, Cazzola M. Comparison of the acute effects of formoterol (F) and formoterol/budesonide combination (FBC) on blood gas tensions in patients with acute exacerbation of COPD (AECOPD)[Abstract]. European Respiratory Journal 2003;22 Suppl 45:P156.
Sagcan 2007 {published data only}
  • Sagcan G, Memis U, Cuhadaroglu C, Sen C, Duygu E. The effects of formoterol/budesonide on sleep quality of COPD patients [Abstract]. European Respiratory Journal 2007;30(Suppl 51):507s [E3049].
SAM40116 {unpublished data only}
  • SAM40116. A 12-Week Multi-centre, Randomised, Double Blind, Parallel Group Study to Compare the Efficacy of Salmeterol/Fluticasone Propionate (Seretide TM) 50/100 mcg or 50/250 mcg Twice Daily and Fluticasone Propionate (Flixotide TM) 250 mcg or 500 mcg Twice Daily via the Diskus TM in Subjects With Asthma/COPD Symptoms. GlaxoSmithKline Clinical Trials Register http:ctr.gsk.co.uk (accessed 2005).
Schermer 2007 {published data only}
  • Schermer TR, Albers JM, Verblackt HW, Costongs RJ, Westers P. Lower inhaled steroid requirement with a fluticasone/salmeterol combination in family practice patients with asthma or COPD. Family Practice 2007;24(2):181-8.
SCO100250 {unpublished data only}
  • GlaxoSmithKline (SCO100250). A Randomized, Double-Blind, Parallel-Group, 52-Week Study to Compare the Effect of Fluticasone Propionate/Salmeterol DISKUS 250/50mcg bid With Salmeterol DISKUS 50mcg bid on the Annual Rate of Moderate/Severe Exacerbations in Subjects With Chronic Obstructive Pulmonary Disease (COPD). http://ctr.gsk.co.uk (accessed 8 April 2008).
SCO100470 {unpublished data only}
  • SCO100470. A Multicentre, Randomised, Double-Blind, Parallel Group, 24-Week Study to Compare the Effect of the Salmeterol/Fluticasone Propionate Combination Product 50/250mcg, With Salmeterol 50mcg Both Delivered Twice Daily via the DISKUS/ACCUHALER Inhaler on Lung Function and Dyspnoea in Subjects With Chronic Obstructive Pulmonary Disease (COPD). GlaxoSmithKline Clinical Trials Register http:ctr.gsk.co.uk (accessed 2006).
SCO40034 {unpublished data only}
  • A Multicentre, Randomised, Double-blind, Double Dummy, Parallel Group 12-Week Exploratory Study to Compare the Effect of the Salmeterol/Fluticasone Propionate Combination Product (SERETIDE) 50/500mcg bd via the DISKUS/ACCUHALER Inhaler With Tiotropium Bromide 18 mcg od via the Handihaler Inhalation Device on Efficacy and Safety in Patients With Chronic Obstructive Pulmonary Disease (COPD). GlaxoSmithKline Clinical Trials Register http:ctr.gsk.co.uk (accessed 2005).
SCO40043 {unpublished data only}
  • SCO40043. A Randomized, Double-Blind, Parallel-Group, 52-Week Study to Compare the Effect of Fluticasone Propionate/Salmeterol DISKUS® 250/50mcg bid With Salmeterol DISKUS® 50mcg bid on the Annual Rate of Moderate/Severe Exacerbations in Subjects With Chronic Obstructive Pulmonary Disease (COPD). http://ctr.gsk.co.uk (accessed 8 April 2008).
Sethi 2006 {published data only}
  • Sethi S, Grove L, Wrona C, Maloney J. Prevalence of bacterial colonization in COPD is not altered by fluticasone/salmeterol. Proceedings of the American Thoracic Society; May 19-22; San Diego. 2006:A115.
Shaker 2009 {published data only}
  • Shaker SB, Dirksen A, Ulrik CS, Hestad M, Stavngaard T, Laursen LC, et al. The effect of inhaled corticosteroids on the development of emphysema in smokers assessed by annual computed tomography. COPD 2009;6(2):104-11.
Sharafkhaneh 2011 {published data only}
  • Sharafkhaneh A, Southard J, Goldman M, Uryniak T, Martin UJ. Long-term effect of budesonide/formoterol pressurized metered-dose inhaler on exacerbations and pulmonary function in patients with chronic obstructive pulmonary disease [Abstract]. American Journal of Respiratory and Critical Care Medicine 2011;183(Meeting Abstracts):A1599.
Soriano 2002 {published data only}
  • Soriano JB, Vestbo J, Pride NB, Kiri V, Maden C, Maier WC. Survival in COPD patients after regular use of fluticasone propionate and salmeterol in general practice. European Respiratory Journal 2002;20(4):797-8.
Southard 2011 {published data only}
  • Southard JG, Sharafkhaneh A, Goldman M, Uryniak T, Martin UJ. Long-term tolerability of budesonide/formoterol pressurized metered-dose inhaler in patients with chronic obstructive pulmonary disease and a history of exacerbations [Abstract]. American Journal of Respiratory and Critical Care Medicine 2011;183(Meeting Abstracts):A1597.
Stallberg 2008 {published data only}
  • Stallberg B, Andersson EBC, Ekstrom T, Selroos O, Vogelmeier C, Larsson K. Budesonide /formoterol for the treatment of COPD exacerbations in the primary healthcare setting [Abstract]. European Respiratory Society Annual Congress; October 4-8; Berlin. 2008:[P3610].
Sun 2004 {published data only}
  • Sun D, Yang J, Xu X. Combined seretide and zafirlukast in the treatment of chronic obstructive pulmonary disease (COPD) [Abstract]. American Thoracic Society 100th International Conference; May 21-26; Orlando. 2004:C22 [Poster 524].
Sutherland 2006 {published data only}
  • Sutherland ER, Moss TA, Stevens AD, Pak J, Martin RJ. Modulation of sputum gene expression in COPD by fluticasone /salmeterol. European Respiratory Journal 2006;28(Suppl 50):662s.
Trofimenko 2006 {published data only}
  • Trofimenko IN, Chernyak BA. The efficacy of salmeterol/fluticasone (SF) for 6 month's therapy at severe COPD patients. European Respiratory Journal 2006;28(Suppl 50):30s.
Vestbo 2004 {published data only}
  • Vestbo J. Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease. Dan. Ugeskrift for Laeger 2004;166(4):271-4.
Welte 2009 {published data only}
  • Welte T, Miravitlles M, Hernandez P, Eriksson G, Peterson S, Polanowski T, et al. Efficacy and tolerability of budesonide/formoterol added to tiotropium in patients with chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine 2009;180(8):741-50.
Welte 2009a {published data only}
  • Welte T, Miravitlles M, Hernandez P, Eriksson G, Peterson S, Polanowski T, et al. Addition of budesonide/formoterol to tiotropium reduces the number of exacerbation days compared with tiotropium alone [Abstract]. Chest 2009;136(4):26S-f.
Welte 2009b {published data only}
  • Welte T, Miravitlles M, Hernandez P, Eriksson G, Peterson S, Polanowski T, et al. Budesonide/formoterol added to tiotropium provides rapid improvements in lung function and ability to undertake morning activities [Abstract]. Chest 2009;136(4):24S-g.
Welte 2009c {published data only}
  • Welte T, Hartman L, Polanowski T, Hernandez P, Miravitlles M, Peterson S, et al. Budesonide/formoterol added to tiotropium is well tolerated and reduces risk of severe exacerbations in COPD patients [Abstract]. American Thoracic Society International Conference; May 15-20; San Diego. 2009:A6188 [Poster #215].
Welte 2009d {published data only}
  • Welte T, Miravitlles M, Hernandez P, Peterson S, Polanowski T, Kessler R, et al. Budesonide/formoterol added to tiotropium improves exacerbations and exacerbation-related antiobiotic use in patients with COPD [Abstract]. European Respiratory Society Annual Congress; September 12-16; Vienna. 2009:[P2012].
Wilson 2007 {published data only}
Worth 2009 {published data only}
  • Worth H, Foerster K, Peterson S, Nihlen U, Magnussen H, et al. Budesonide/formoterol improves exercise tolerance compared with placebo and formoterol in COPD patients [Abstract]. European Respiratory Society Annual Congress; September 12-16; Vienna. 2009:[201].
Worth 2009a {published data only}
  • Worth H, Peterson S, Nihlen U, Magnussen H. Improved exercise tolerance with budesonide/formoterol vs placebo and formoterol in COPD patients [Abstract]. American Thoracic Society International Conference, May 15-20, San Diego. 2009:A6193 [Poster #220].
Worth 2010 {published data only}
  • Worth H, Förster K, Eriksson G, Nihlén U, Peterson S, Magnussen H. Budesonide added to formoterol contributes to improved exercise tolerance in patients with COPD. Respiratory Medicine 2010; Vol. 104, issue 10:1450-9.
Wouters 2005 {published data only}
  • Creutzberg EC, Bookelmann YJH, Hop WCJ, Postma DS, Wouters EFM. Determinants of health status in patients with COPD. http://www.abstracts2view.com (accessed 1 April 2007):A107 [Poster C31].
  • Creutzberg EC, Bookelmann YJH, Hop WCJ, Postma DS, Wouters EFM. Predicting factors for an acute exacerbation of COPD in the COSMIC study. http://www.abstracts2view.com (accessed 1 April 2007).
  • Rizzato G. COPD: Immediate and sustained deterioration after withdrawal of fluticasone in patients under therapy with salmeterol + fluticasone. Internista 2005;13(4):225-30.
  • Wouters EF, Postma DS, Fokkens B, Hop WC, Prins J, Kuipers AF, et al. Withdrawal of fluticasone propionate from combined salmeterol/fluticasone treatment in patients with COPD causes immediate and sustained disease deterioration: a randomised controlled trial. Thorax 2005;60(6):480-7.
  • Wouters EF, Postma DS, Fokkens B, Hop WC, Prins J, Kuipers AF. The Cosmic COPD and Serentide: A Multi-Center Intervention and Characterization Study Group. Withdrawal of fluticasone propionate from combined salmeterol/fluticasone treatment in patients with COPD causes immediate and sustained disease deterioration: a randomised controlled trial [A remocao do propionato de fluticasona da terapeutica combinada com salmeterol/fluticasona em doentes com DPOC causa agravamento imediato e mantido; um estudo randomizado e controlado]. Revista Portuguesa De Pneumologia 2005;11(6):587-9.
  • Wouters EFM. COPD and seretide: a multi-center intervention and characterisation (COSMIC) study: a rationale and baseline characteristics. European Respiratory Journal 2002;20(38):P1571.
  • Wouters EFM, Postma DS, Fokkens B, Hop WCJ, Creutzberg EC. One year withdrawal of fluticasone after three month treatment with combined fluticasone/salmeterol in COPD [Abstract]. American Thoracic Society 100th International Conference; May 21-26; Orlando. 2004:C22 [Poster 516].
Zhong 2011 {published data only}
  • Zhong N, Zheng J, Wen F, Yang L, Chen P, Xiu Q, et al. Efficacy and safety of inhalation of budesonide/formoterol via turbuhaler in Chinese patients with chronic obstructive pulmonary disease [Abstract]. Chest 2011;140(4):5225A.
Zhong 2012 {published data only}
  • Zhong N, Zheng J, Wen F, Yang L, Chen P, Xiu Q, et al. Efficacy and safety of budesonide/formoterol via a dry powder inhaler in Chinese patients with chronic obstructive pulmonary disease. Current Medical Research and Opinion 2012;28(2):257-65.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
ACP 2011
  • ACP, ACCP, ATS, ERS. Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Annals of Internal Medicine 2011;155:179-91.
Barnes 2002
Cates 2012
Cosio 2009
Dong 2013
  • Dong YH, Lin HH, Shau WY, Wu YC, Chang CH, Lai MS. Comparative safety of inhaled medications in patients with chronic obstructive pulmonary disease: systematic review and mixed treatment comparison meta-analysis of randomised controlled trials. Thorax Jan 2013;68(1):48-56.
Donohue 2005
  • Donohue JF. Minimally clinically important differences in COPD lung function. COPD 2005;2:111–24.
Ducharme 2010
  • Ducharme FM, Ni Chroinin M, Greenstone I, Lasserson TJ. Addition of long-acting beta2-agonists to inhaled corticosteroids versus same dose inhaled corticosteroids for chronic asthma in adults and children. Cochrane Database of Systematic Reviews 2010, Issue 5. [DOI: 10.1002/14651858.CD005535.pub2]
Garcia-Aymerich 2011
  • Garcia-Aymerich J, Serra Pons I, Mannino DM, Maas AK, Miller DP, Davis KJ. Lung function impairment, COPD hospitalisations and subsequent mortality. Thorax 2011;66(7):585-90.
GOLD 2012
  • GINA Science Committee. From the Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2012. http://www.ginasthma.org (accessed 9 July 2013).
Hanania 2011
Higgins 2011
  • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. www.cochrane-handbook.org.
Jones 2005
  • Jones PW. St. George's Respiratory Questionnaire: MCID. COPD March 2005;2(1):75-9.
Karner 2011
  • Karner C, Cates CJ. Combination inhaled steroid and long-acting beta2-agonist in addition to tiotropium versus tiotropium or combination alone for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews 2011, Issue 3. [DOI: 10.1002/14651858.CD008532.pub2]
Kesten 2007
Leidy 2003
  • Leidy NK, Rennard SI, Schmier J, Jones MKC, Goldman M. The Breathlessness, Cough, and Sputum Scale.* The Development of Empirically Based Guidelines for Interpretation. Chest 2003;124:2182-91.
McGarvey 2007
Nannini 2012
Nannini 2013
  • Nannini LJ, Poole P, Milan SJ, Kesterton A. Combined corticosteroid and long-acting beta2-agonist in one inhaler versus inhaled corticosteroids alone for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews 2013, Issue 8. [DOI: 10.1002/14651858.CD006826.pub2]
NCGC2010
  • National Clinical Guidelines Centre. Management of chronic obstructive pulmonary disease in adults in primary and secondary care. http://publications.nice.org.uk/chronic-obstructive-pulmonary-disease-cg101 (accessed 9 July 2013).
Ni Chroinin 2009
RevMan 2011
  • The Cochrane Collaboration. Copenhagen: The Nordic Cochrane Centre. Review Manager (RevMan). Version 5.1.. The Cochrane Collaboration. Copenhagen: The Nordic Cochrane Centre, 2011.
Suissa 2006
  • Suissa S. Statistical treatment of exacerbations in therapeutic trials of chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine 2006;173(8):842-6.
UPLIFT 2008
  • Tashkin DP, Celli B, Senn S, Burkhart D, Kesten S, Menjoge S, et al. for the UPLIFT Study Investigators. A 4-year trial of tiotropium in chronic obstructive pulmonary disease. New England Journal of Medicine Oct 9 2008;359(15):1543-54.
Visual Rx
  • Cates CJ. Visual Rx Version 3.0. www.nntonline.net (accessed 9 July 2013).
Walters 2007
Yang 2012

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Nannini 2003
  • Nannini L, Lasserson TJ, Poole P. Combined corticosteroid and long-acting beta-agonist in one inhaler for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews 2003, Issue 4. [DOI: 10.1002/14651858.CD003794.pub2]
Nannini 2004
  • Nannini L, Cates CJ, Lasserson TJ, Poole P. Combined corticosteroid and long-acting beta-agonist in one inhaler for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews 2004, Issue 3. [DOI: 10.1002/14651858.CD003794.pub2]
Nannini 2007
  • Nannini L, Cates CJ, Lasserson TJ, Poole P. Combined corticosteroid and long-acting beta-agonist in one inhaler versus inhaled steroids for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews 2007, Issue 4. [DOI: 10.1002/14651858.CD006826]