Asthma diagnosis and treatmentThe effects of inhaled budesonide and formoterol in combination and alone when given directly after allergen challenge
Section snippets
Methods
Sixteen atopic adults (≥18 years) with stable mild asthma and FEV1 ≥80% predicted were recruited. All were nonsmokers, taking only short-acting β2-agonists as needed, and demonstrated a methacholine PC20 of <16 mg/mL. Subjects also demonstrated a maximum fall in FEV1 ≥20% to inhaled allergen within 0 to 3 hours (early airway response; EAR) and ≥15% between 3 and 7 hours (late airway response; LAR) at screening challenge. The same dose of allergen causing the dual response was subsequently used
Results
One subject was withdrawn before randomization because of an asthma exacerbation. Screening baseline characteristics for the 15 completed subjects are presented in Table I. Baseline values for the 4 randomized periods were not significantly different, and no carryover effect was detected. Furthermore, no significant difference in FEV1 and FEV1/vital capacity was seen on days 1 to 3 between the periods (Table II). Serial FEV1 measurements after each allergen challenge (and treatment) up to 7
Discussion
This study demonstrated that single doses of budesonide/formoterol, formoterol, and budesonide administered after allergen inhalation significantly attenuated the LAR. Budesonide/formoterol was superior to its monocomponents in this regard and provided protection against allergen-induced airway hyperresponsiveness (AHR), whereas treatment with the monocomponents did not achieve this benefit. Treatments with formoterol and budesonide/formoterol were equally effective in alleviating the EAR.
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Supported in part by AstraZeneca, Lund, Sweden.
Disclosure of potential conflict of interest: G. Gauvreau has consultant arrangements with Topigen Pharma Inc, Tanox, Novartis Pharma UK Ltd, MedImmune Inc, and Altana Inc and has received grant support from Pfizer, Altana, GlaxoSmithKline, Topigen, and MedImmune. P. M. O'Byrne has consultant arrangements with Altana, AstraZeneca, GlaxoSmithKline, Topigen, and Biolipox and has received grant support from Altana, AstraZeneca, GlaxoSmithKline, Topigen, Biolipox, MedImmune, Pfizer, IVAX, and Boehringer Ingleheim. The rest of the authors have declared that they have no conflict of interest.
Some of the data from this paper were presented in abstract form at the American Thoracic Society Meeting, May 2006, San Diego, Calif.