Rapid onset of bronchodilation in COPD: a placebo-controlled study comparing formoterol (Foradil®AerolizerTM) with salbutamol (VentodiskTM)

AbstractFormoterol fumarate is a β2-agonist bronchodilator that combines a fast onset of action with a long duration of action. Its fast onset of action is well documented in asthma but has not been directly compared with that of salbutamol in patients with chronic obstructive pulmonary disease (COPD). This randomized, double-blind, placebo-controlled study was conducted to assess the bronchodilatory effects over the first 3 h after inhalation of single doses of formoterol 24 μ g delivered via the AerolizerTMdry powder inhaler device (double-blind), or salbutamol 400μ g delivered via Diskhaler®dry powder inhaler (single-blind) in patients with COPD. A total of 24 patients with COPD were randomized [mean age 61·6±7·8 years, mean forced expiratory volume in 1 sec (FEV1) 1·38±0·32 l and 45·8±9·6% of predicted]. Inhalation of formoterol or salbutamol resulted in similar increases in FEV1from 0 to 3 h post-dose. Both drugs produced similar bronchodilation by 5 min, which became almost maximal by 30 min. The primary efficacy variable, the area under the curve (AUC) of the FEV1increase above predose baseline from 0 to 30 min (AUC0−30 min), demonstrated significant effects for formoterol (mean 5·89±4·67 l min−1), and salbutamol (mean 6·06±4·34 l min−1), which were not statistically different from each other but statistically significantly higher (P