PT  - JOURNAL ARTICLE
AU  - Janine Pilcher
AU  - Mitesh Patel
AU  - Ann Smith
AU  - Cheryl Davies
AU  - Justin Travers
AU  - Mark Weatherall
AU  - Richard Beasley
AU  - Matire Harwood
TI  - The budesonide/formoterol inhaler as maintenance and reliever therapy in Maori asthmatics
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P3838
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P3838.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P3838.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - Introduction: As the SMART regimen (combination budesonide/formoterol inhaler for maintenance and relief) may have a favourable risk/benefit profile in asthma, it may confer specific benefits for ethnic groups with a disproportionate burden of disease, such as Maori (the indigenous population of New Zealand). Aim: To investigate outcomes for Maori versus non-Maori in a randomised controlled trial (RCT) investigating the SMART regimen. Methods: In a multicentre 24 week RCT in 303 adult asthma patients (including 44 Maori), electronic inhaler monitoring data and clinical outcomes were analysed in patients randomised to SMART or a Standard (combination budesonide/formoterol inhaler for maintenance and salbutamol for relief) regimen. Differences in Maori versus non-Maori were analysed via an interaction term for ethnicity. Results: With adjustment for ethnicity, SMART resulted in improvement in the following outcomes: days of high inhaler use (>12 actuations/day of budesonide/formoterol in SMART or >16 actuations/day of salbutamol for Standard) (Relative Rate (95%CI) 0.57(0.38-0.85)), days of maintenance inhaler non-adherence, days of high inhaler use without medical review and number of severe exacerbations. The benefits of SMART were similar in magnitude for Maori and non-Maori. Independent of treatment regimen, Maori had increased rates of high inhaler use, inhaler non adherence and high inhaler use without medical review. Conclusions: The SMART regimen has favourable outcomes in Maori with asthma, which may be generalisable to other ethnic populations with increased asthma burden. Funding: Health Research Council of New Zealand.