Chest
Original ResearchBronchiectasisClinical Efficacy and Safety of Budesonide-Formoterol in Non-Cystic Fibrosis Bronchiectasis
Section snippets
Patients
We studied all patients between 18 and 80 years old with non-CF bronchiectasis diagnosed in our center. Inclusion criteria were known chronic airflow obstruction and clinically stable phase (ie, subjects free from acute exacerbation for at least 6 weeks prior to the start of the study). Exclusion criteria were cigarette smoking history of > 10 pack-years, occupational risk for COPD, chronic oral steroid treatment, traction bronchiectasis due to advanced fibrosis, known intolerance for ICS or
Results
Out of the 131 patients initially considered, 88 presented airflow obstruction. Out of these patients, 43 remained in the study after inclusion and exclusion criteria. During the run-in period, three additional patients were excluded for clinical instability following the change of treatment to high-dose budesonide. Finally, 40 patients were suitable for randomization (Fig 1). The causes finally identified were idiopathic in 19 cases (47.5%), postinfection in nine cases (22.5%), post TB in
Discussion
According to our results, formoterol plus medium-dose budesonide combined treatment showed a better clinical effectiveness and safety profile than high-dose budesonide treatment. Combined treatment caused a significant improvement, both statistically and clinically, of dyspnea, a decrease in number of cough days and wheeze self-perceived by patient, a reduction in the dose of rescue β2-agonist needed, and an improvement of HRQL, as well as a decrease in the percentage of side effects. Despite
Acknowledgments
Author contributions: Dr Martínez-García: contributed to designing the study, data acquisition and interpretation, supervising the study, and writing the manuscript.
Dr Soler-Cataluña: contributed to designing the study, data acquisition and interpretation, and approving the final version to be published.
Dr Catalán-Serra: contributed to data acquisition and interpretation, critically revised the manuscript, and approved the final version to be published.
Dr Román-Sánchez: contributed to data
References (24)
Bronchiectasis
Chest
(2008)- et al.
Quality-of-life determinants in patients with clinically stable bronchiectasis
Chest
(2005) - et al.
Diagnosis and treatement of bronchiectasis. Spanish Society of Pneumology and Thoracic Surgery [in Spanish]
Arch Bronconeumol
(2008) - et al.
Inhaled steroids in patients with bronchiectasis
Respir Med
(1992) - et al.
Inhaled steroids improve quality of life in patients with steady-state bronchiectasis
Respir Med
(2006) - et al.
Internal consistency and validity of the Spanish version of St. George's respiratory questionnaire for use in patients with clinically stable bronchiectasis in Spanish]
Arch Bronconeumol
(2005) - et al.
The St George's Respiratory Questionnaire
Respir Med
(1991) - et al.
The measurement of dyspnea. Contents, interobserver agreement, and physiologic correlates of two new clinical indexes
Chest
(1984) - et al.
Treatment of bronchiectasis in adults
BMJ
(2007) - et al.
Budesonide turbuhaler delivered once daily improves health-related quality of life in adult patients with non-steroid-dependent asthma
Allergy Asthma Proc
(2003)
Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease
N Engl J Med
Clinical effects of inhaled corticosteroids in chronic obstructive pulmonary disease
Proc Am Thorac Soc
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2018, Medical Journal of AustraliaCitation Excerpt :A Cochrane review of inhaled corticosteroid (ICS) use in bronchiectasis concluded that the evidence did not support routine use of ICS and posed a risk of adverse effects.57 Evidence for long term use of inhaled long-acting β-agonists (LABA) in stable bronchiectasis is limited to one unblinded trial in 40 subjects, comparing combined ICS/LABA (budesonide 640 μg and formoterol 18 μg) with high dose ICS (budesonide 1600 μg).58 Patients who received ICS/LABA had less dyspnoea and more cough-free days after 3 months of treatment than those on ICS alone, with no difference in lung function or exacerbations.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).
Funding/Support: This study has received a grant from Esteve S.A. and Sociedad Valenciana de Neumología.