Chest
Original ResearchAsthmaIncreasing Doses of Inhaled Corticosteroids Compared to Adding Long-Acting Inhaled β2-Agonists in Achieving Asthma Control
Section snippets
Study Design
Patients and study design have been described in detail elsewhere.5 Eligible patients were randomly assigned to one of the following regimens (administered twice daily) for 12 months: 100 μg of budesonide plus placebo (Bud 200 μg/d); 100 μg of budesonide plus 12 μg of formoterol (daily dose, 24 μg) [Oxis; AstraZeneca; Lund, Sweden] (Bud 200 μg/d + Form); 400 μg of budesonide plus placebo (Bud 800 μg/d); and 400 μg of budesonide plus 12 μg of formoterol (daily dose, 24 μg) [Bud 800 μg/d + Form].
Results
Of the 1,114 patients entering the run-in period, 262 were excluded from the study before randomization because they did not meet the randomization criteria. The remaining 852 patients were randomly assigned to treatment. Baseline demographic characteristics are presented in Table 1. The differences in baseline data among the groups were minor. During the budesonide run-in period with a dose of 800 μg twice daily, the mean use of as-needed rescue medication and the incidence of awakenings
Discussion
The aim of this post hoc analysis of the FACET data set was to clarify the role of increasing ICS doses, with and without LABA therapy, in increasing the time spent with well-controlled asthma and in reducing the time spent with poorly controlled asthma. To achieve this, we focused, for the first time, on both good and bad composite control of asthma. This revealed a clear benefit for both LABAs and higher doses of ICSs in stabilizing asthma control. Our findings confirm that in patients with
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Cited by (60)
Comparative efficacy and tolerability of beclomethasone/formoterol and fluticasone/salmeterol fixed combination in Taiwanese asthmatic patients
2018, Journal of the Formosan Medical AssociationCitation Excerpt :International guidelines such as Global initiative for asthma (GINA) 20174 and Expert Panel Report 35 have suggested the combination of long-acting β2-agonist (LABA) with low-medium dose of inhaled corticosteroids (ICS) when asthma is not well-controlled by ICS alone. This evidence is supported by the results of several randomized controlled trials showing a better asthma control when combinations are used in patients not controlled on ICS alone, as compared to the increase in the ICS dose.6–8 Among current combination therapies (ICS/LABA), beclomethasone/formoterol (BDP/F, 100/6 μg) is one of the latest combination inhaled therapy available for asthma treatment.
Achieving asthma control with ICS/LABA: A review of strategies for asthma management and prevention
2016, Respiratory MedicineCitation Excerpt :In patients whose asthma is not well controlled with a low dose of ICS, there are two possible strategies that can be used to improve control: increasing the dose of ICS or adding a LABA [1]. However, concern has been expressed that the addition of a LABA to a low dose of ICS may enhance current control but mask inflammation, therefore increasing future risk [20,21]. In the FACET study, patients who had stable asthma after a run-in period were randomised to receive budesonide (at a low or high dose) in combination with either formoterol or placebo (Table 1) [3].
Evaluating as-needed inhaled corticosteroid strategies in asthma: expanding the benefits to mild asthma
2023, Expert Review of Respiratory MedicineImpact of asthma control on quality of life in an outpatient setting in Brazil
2023, Journal of Asthma
The FACET study was supported by AstraZeneca R&D (Lund, Sweden).
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).
- 1
Drs. O'Byrne, Postma, and Barnes have been consultants to AstraZeneca, and have received speakers fees and grants-in-aid from AstraZeneca.
- 2
Mr. Naya and Dr. Kallen are employed by AstraZeneca and own stock.