RT Journal Article
SR Electronic
T1 Effect of different asthma treatments on risk of cold-related exacerbations
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj01865-2010
DO 10.1183/09031936.00186510
A1 H.K. Reddel
A1 C. Jenkins
A1 S. Quirce
A1 M.R. Sears
A1 E.D. Bateman
A1 P.M. O’Byrne
A1 M. Humbert
A1 R. Buhl
A1 T. Harrison
A1 G.G. Brusselle
A1 A. Thorén
A1 U. Sjöbring
A1 S. Peterson
A1 O. Östlund
A1 G.S. Eriksson
YR 2011
UL http://erj.ersjournals.com/content/early/2011/03/10/09031936.00186510.abstract
AB Common colds often trigger asthma exacerbations. This analysis compared cold-related severe exacerbations during budesonide/formoterol maintenance and reliever therapy and different regimens of maintenance inhaled corticosteroid (ICS) ± long-acting β2-agonist (LABA) with as-needed short-acting β2-agonist (SABA) or LABA,.Reported colds, and severe exacerbations (defined by oral corticosteroid use and/or hospitalisation/emergency room visit) were assessed for 12507 patients during 6–12 months’ double-blind treatment. Exacerbations occurring ≤14 days after onset of reported colds were analysed by a Poisson model.Incidence of colds was similar across treatments. Asthma symptoms and reliever use increased during colds. Budesonide/formoterol maintenance and reliever therapy reduced severe cold-related exacerbations by 36% versus pooled comparators plus SABA (rate ratio [RR] 0.64; P=0.002), and, for individual treatment comparisons, by 52% versus same maintenance dose ICS/LABA (RR 0.48; P<0.001); there were non-significant reductions versus higher maintenance doses of ICS or ICS/LABA (RR 0.83 and 0.72). As-needed LABA did not reduce cold-related exacerbations versus as-needed SABA (RR 0.96).Severe cold-related exacerbations were reduced by budesonide/formoterol maintenance and reliever therapy compared with ICS±LABA with as-needed SABA. Subanalyses suggest the importance of the ICS component in reducing cold-related exacerbations. Future studies should document the cause of exacerbations, to allow identification of different treatment effects.