A proof of concept study to evaluate stepping down the dose of fluticasone in combination with salmeterol and tiotropium in severe persistent asthma

We conducted a double blind, randomised, placebo-controlled, crossover study evaluating the effects of halving inhaled steroid dosage plus salmeterol, or salmeterol and tiotropium. Eighteen life-long non-smoking severe asthmatics [mean FEV1 1.49l (51%)] were run-in for 4 weeks on HFA-fluticasone propionate 1000μg daily, and were subsequently randomised to 4 weeks of either (a) HFA-fluticasone propionate 500μg BD/salmeterol 100μg...