Abstract
I read with interest the article by Kosoglou et al (December 2013)1 comparing the relative adrenal suppression of mometasone furoate/formoterol (MF/F) vs fluticasone propionate/salmeterol (FP/S) combination inhalers via metered-dose inhalers in patients with mild to moderate asthma. The geometric mean ratio for cortisol area under curve (AUC) comparing MF/F 400/10 μg bid (n = 15) vs FP/S 460/42 μg bid (n = 16) was 1.19 (90% CI, 1.01-1.40), which, although falling within predefined ± 30% equivalence limits (ie, corresponding to a ratio of 0.70-1.43), clearly represents a significant difference, as the lower CI exceeds unity, indicating that FP produces greater adrenal suppression than MF when used at higher doses.
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