regular use of salmeterol/fluticasone propionate (Seretide) significantly reduces asthma exacerbations compared with alternative combination treatments [i].

Results

-- -- The EXCEL (EXacerbation Control Evaluated in a 6 month Long) study showed that patients treated with salmeterol/fluticasone propionate showed a rate of moderate-severe exacerbations that was 57% lower than those treated with formoterol/budesonide1.

-- -- The results of the EXCEL study are in sharp contrast to current asthma management in the UK whereby patients often take variable amounts of their anti-inflammatory treatment and rely on taking rescue treatment to react to their breakthrough symptoms.

-- -- Earlier in the year the GINA Global Burden of Asthma Report showed that in the UK around a quarter of adults have asthma symptoms, and highlighted the tendency of care to be reactive to acute symptoms rather than preventative. [ii]

Design

-- -- The 24 week EXCEL study was a parallel group, randomised, double blind, double-dummy multicentre study which compared exacerbation rates on salmeterol/fluticasone propionate (SF) and formoterol/budesonide (FB) combination treatments in persistent asthmatics.

-- -- The EXCEL study was conducted in over 1,000 patients.

-- -- Exacerbations were defined as:

-- Mild (drop of PEF of 20% over 2 consecutive days)
-- Moderate (course of oral steroid)
-- Severe (in patient hospitalisation/emergency treatment)