Inhaled Fluticasone/Salmeterol Better Than Fluticasone Alone for Moderate to Severe Asthma


Am Fam Physician. 2016 Sep 1;94(5):387.

Clinical Question

Is the combination of a long-acting beta agonist and an inhaled corticosteroid as safe and effective as an inhaled corticosteroid alone?

Bottom Line

The combination of fluticasone and salmeterol (Advair), with the steroid dose adjusted for disease severity, reduces the number of severe asthma exacerbations more than fluticasone (Flovent) alone (number needed to treat [NNT] = 50 over 26 weeks), with no difference in terms of potential harms, such as intubation or asthma-related death. (Level of Evidence = 1b)


This study was performed by GlaxoSmithKline at the behest of the U.S. Food and Drug Administration because of enduring concerns about the safety of long-acting beta agonists. The authors identified patients with moderate to severe asthma who had experienced at least one exacerbation in the previous

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

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This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.


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May 1, 2017

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