|
 |
|
|||||||
|
|||||||||
Copyright ©ERS Journals Ltd 2005
Budesonide/formoterol maintenance and reliever therapy: an effective asthma treatment option?
31 Marburg University, Marburg, Germany, 2 Primary Care Lung Clinic, Toronto, Canada. 3 Ghent University Hospital, Ghent, Belgium. 4 Hospital Donostia, Donostia-San Sebastiàn, Spain. 5 Private Practice, Coventry, and 8 Dept of General Practice and Primary Care, University of Aberdeen, Aberdeen, UK, 6 Private Practice, Nantes, France 7 AstraZeneca, Lund, Sweden.
CORRESPONDENCE: C. Vogelmeier, Klinikum der Philipps-Universität Marburg, Baldingerstrasse, 35043 Marburg, Germany. Fax: 49 64212868987. E-mail: Claus.Vogelmeier{at}med.uni-marburg.de
Keywords: Asthma, budesonide/formoterol, salmeterol/fluticasone, Seretide®/Advair®, Symbicort®
Received: March 10, 2005
Accepted August 5, 2005
This 12-month dose-titration study assessed the effectiveness of budesonide/formoterol for maintenance plus relief with a control group using salmeterol/fluticasone for maintenance plus salbutamol for relief.
Adolescents and adults (n = 2,143; mean forced expiratory volume in one second (FEV1) 73% predicted; mean inhaled corticosteroid (ICS) 884 µg·day–1) were randomised to budesonide/formoterol 160/4.5 µg two inhalations b.i.d. plus additional inhalations as needed, or salmeterol/fluticasone 50/250 µg b.i.d. plus salbutamol as needed. Treatment was prescribed open label; after 4 weeks, physicians could titrate maintenance doses in accordance with normal clinical practice.
Maintenance plus as-needed budesonide/formoterol prolonged the time to first severe exacerbation versus salmeterol/fluticasone (25% risk reduction). The total number of severe exacerbations was significantly reduced in the budesonide/formoterol group (255 versus 329). Both regimens provided sustained improvements in symptoms, as-needed use, quality of life and FEV1, with differences in favour of the budesonide/formoterol group for as-needed use (0.58 versus 0.93 inhalations·day–1) and FEV1 (post-ß2-agonist values). Mean ICS dose during treatment was similar in both groups (653 µg budesonide·day–1 (maintenance plus as-needed) versus 583 µg fluticasone·day–1).
The simplified strategy using budesonide/formoterol for maintenance and reliever therapy is feasible, safe and at least as effective as salmeterol/fluticasone plus salbutamol.
This article has been cited by other articles:
|
|
 |
|
  B. Lindmark Review: Differences in the pharmacodynamics of budesonide/formoterol and salmeterol/fluticasone reflect differences in their therapeutic usefulness in asthma Therapeutic Advances in Respiratory Disease, October 1, 2008; 2(5): 279 - 299. [Abstract] [PDF]
|
|
|
|
|
|
L. Bjermer Review: Evaluating combination therapies for asthma: pros, cons, and comparative benefits Therapeutic Advances in Respiratory Disease, June 1, 2008; 2(3): 149 - 161. [Abstract] [PDF]
|
|
|
|
 |
|
 M. R. Sears, L-P. Boulet, M. Laviolette, J. M. Fitzgerald, T. R. Bai, A. Kaplan, N. Smiljanic-Georgijev, and J. S-M. Lee Budesonide/formoterol maintenance and reliever therapy: impact on airway inflammation in asthma Eur. Respir. J., May 1, 2008; 31(5): 982 - 989. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. D. Bateman, S. S. Hurd, P. J. Barnes, J. Bousquet, J. M. Drazen, M. FitzGerald, P. Gibson, K. Ohta, P. O'Byrne, S. E. Pedersen, et al. Global strategy for asthma management and prevention: GINA executive summary Eur. Respir. J., January 1, 2008; 31(1): 143 - 178. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. J Barnes Using a combination inhaler (budesonide plus formoterol) as rescue therapy improves asthma control BMJ, September 8, 2007; 335(7618): 513 - 513. [Full Text] [PDF]
|
|
|
|
 |
|
 J M FitzGerald and P G Gibson Asthma exacerbations {middle dot} 4: Prevention. Thorax, November 1, 2006; 61(11): 992 - 999. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |