PT - JOURNAL ARTICLE AU - Susan Muiser AU - Bart Luijk AU - Gert-Jan Braunstahl AU - Irene Heijink AU - Helen Reddel AU - Huib Kerstjens AU - Maarten Van Den Berge TI - Budesonide/formoterol maintenance and reliever therapy versus fluticasone/salmeterol fixed-dose treatment in patients with COPD AID - 10.1183/13993003.congress-2020.5237 DP - 2020 Sep 07 TA - European Respiratory Journal PG - 5237 VI - 56 IP - suppl 64 4099 - http://erj.ersjournals.com/content/56/suppl_64/5237.short 4100 - http://erj.ersjournals.com/content/56/suppl_64/5237.full SO - Eur Respir J2020 Sep 07; 56 AB - Introduction: In asthma, maintenance and reliever therapy (MART) with inhaled corticosteroid (ICS)/formoterol reduces exacerbations compared to fixed-dose therapy with ICS/long-acting β2-agonist. No studies have investigated MART in patients with chronic obstructive pulmonary disease (COPD).Methods: COPD patients (smoking >10 pack years; post-bronchodilator FEV1 <80% predicted) with ≥1 exacerbation in the previous 2 years, were randomly assigned 1:1 ratio to open-label MART (Spiromax® budesonide/formoterol 160/4.5 mg 2 inhalations twice daily + 1 prn) or fixed-dose therapy (Diskus® fluticasone/salmeterol 500/50 mg 1 inhalation twice daily + salbutamol 100 µg prn) for one year. The primary outcome was number of exacerbations.Results: 194 patients were randomised (MART n=103; fixed-dose n=91). No significant difference was seen between MART and fixed-dose therapy in number of exacerbations (58 vs 52, respectively, relative risk (RR) 0.98 [95% CI 0.77-1.26]; p=0.90) (table 1). Similar proportions of patients reported adverse events (MART: 73.1% vs fixed-dose: 67.1%, p=0.38), but more patients had pneumonia with MART vs fixed-dose therapy (8 [7.8%] vs 1 [1.1%], respectively, RR 7.07 [95% CI 0.90-55.44]; p=0.04).Conclusions: In COPD, budesonide/formoterol MART is equally effective as fluticasone/salmeterol fixed-dose therapy, but pneumonia was more common with budesonide/formoterol MART.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 5237.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).