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The combination of inhaled steroids with long-acting beta-2-agonists (fluticasone + salmeterol;seretide)has been demonstrated to achieve a42 percent reduction in the rate of exacerbations requiring oralcorticosteroids, as compared to placebo (p<0.001) (figure 2).

in addition, combination therapy reduces several’s inflammatory cells and cytokines with a resultant decrease in the inflammation associated with COPD.

Combination therapy with fluticasone

and salmaterol substantially reduced a

number of key inflammatory calls and

cytokines in COPD patients

in a double blind, placebo controlled, biopsy study,treatment with seretide.resulted in a significant reductions of 36 percent in CD8 + T-cells over placebo (p=0.001),togheter with significant  decrease in sputum neutrophils as compared reduced a number of key inflammatory cells and cytkokines  including CD4+T-lymphocytes, CD45, mast cells, tumor necrosis factor-alpa (TNFa)+ cells and interferon-gamma (IFN-y) (figured 3).these anti-inflammatory effects were accompanied by a 173 -ml improvements in prebronchodilator  FEV (p<0.001).similar changes have not been demonstrated in studies with steroid theraphy alone.

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