A comparison of two long-acting β-agonists, oral bambuterol and inhaled salmeterol, in the treatment of moderate to severe asthmatic patients with nocturnal symptoms

AbstractThis multicentre study was set up to compare the efficacies of two long-acting β2-agonists, oral bambuterol (20 mg nocte) and inhaled salmeterol (50 μg b.i.d.), for the treatment of moderate to severe asthmatics who were considered to be on optimal steroid/bronchodilator therapy, but continued to have troublesome nocturnal symptoms.The study was of double-blind, parallel-group design and comprised a 2-week run-in on previous maintenance therapy followed by a 6-week study treatment period. There were 117 randomized asthmatic patients aged 20–70 years (65 women and 52 men with a mean age of 45 and predicted FEV1 of 64%), who had been taking 800–2000 μg inhaled steroid and/or up to 20 mg oral steroid per day for at least 4 weeks. They were asked to complete daily diary cards, recording morning and evening PEF, daily symptoms, nocturnal awakenings, rescue medication and subjective tremor.There was a significant increase in both morning and evening PEF respectively, on bambuterol (28 l min−1, 20 l min−1, P<0·05) and salmeterol (29 l min−1, P<0·001; 23 l min−1, P<0·01) when compared with run-in. The mean percentage fall in overnight PEF was reduced by 8·3% (P<0·001) on bambuterol and by 6·8% (P