Comparison of the effectiveness and safety of formoterol versus salmeterol in the treatment of patients with asthma: A systematic review and meta-analysis

Formoterol and salmeterol are two long-acting? 2-agonists given by inhalation, with bronchodilating eff ects lasting for at least 12 h after a single administration. Formoterol has a faster onset of action compared with salmeterol. The aim of this study was to perform a systematic review and meta-analysis on the data published from previous review in order to calculate pooled estimates of eff ectiveness and safety assessment of formoterol and salmeterol in treatment of patients with asthma. In this study, we conducted an electronic search for medical citation databases including Cochrane, PubMed, Scopus,PsycInfo, and IranMedex. Besides manual search of the databases that record randomized clinical trials, conference proceedings,and journals related to asthma were included. Studies were evaluated by two independent people based on inclusion and exclusion criteria, and the common outcomes of studies were entered into the RevMan 5.0.1 software, after evaluation of studies and extraction of data from them; and in cases where there were homogeneous studies, meta-analysis was performed, and for heterogeneous studies,the results were reported qualitatively. Of the 1539 studies initially found, 13 were included in the study. According to the meta-analysis conducted, no signifi cant diff erence was found between the inhalation of formoterol 12? g and salmeterol 50? g in the two outcomes of mean forced expiratory volume 1 s (FEV1), 12 h after inhalation of medication and Borg score (A frequently used scale for quantifying breathlessness) after inhalation of medication. In addition, salmeterol was more eff ective than formoterol in the two outcomes of percent decrease in FEV1 after inhalation of methacholine and the number of days without an attack. Since the two outcomes of FEV1 30-60 min after inhalation of medication and morning peak expiratory flow after inhalation of medication were heterogeneous, they had no meta-analysis capabilities, and its results were reported qualitatively. The data from included studies shows that, more effi cacy has been achieved with Salmeterol, especially in some outcomes such as the percent decrease in FEV1 after inhalation of Methacholine, and the number of days without an attack; and therefore, the administration of Salmeterol seems to be benefi cial for patients, compared with Formoterol.