Journal Article10.1164/RCCM.200407-884OC
Budesonide/formoterol combination therapy as both maintenance and reliever medication in asthma
Paul M. O'Byrne,Hans Bisgaard,Philippe Godard,Massimo Pistolesi,Mona Palmqvist,Yuanjue Zhu,Tommy Ekström,Eric D. Bateman +7 more
TL;DR: Bud/form maintenance + relief prolonged the time to first severe exacerbation (p < 0.001), reduced severe exacerbations rate, and improved symptoms, awakenings, and lung function compared with both fixed dosing regimens.
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Abstract: Asthma control is improved by combining inhaled corticosteroids with long-acting beta2-agonists. However, fluctuating asthma control still occurs. We hypothesized that in patients receiving low maintenance dose budesonide/formoterol (bud/form), replacing short-acting beta2-agonist (SABA) reliever with as-needed bud/form would provide rapid symptom relief and simultaneous adjustment in antiinflammatory therapy, thereby reducing exacerbations. In this double-blind, randomized, parallel-group study, 2,760 patients with asthma aged 4-80 years (FEV1 60-100% predicted) received either terbutaline 0.4 mg as SABA with bud/form 80/4.5 microg twice a day (bud/form + SABA) or bud 320 microg twice a day (bud + SABA) or bud/form 80/4.5 microg twice a day with 80/4.5 microg as-needed (bud/form maintenance + relief). Children used a once-nocte maintenance dose. Bud/form maintenance + relief prolonged time to first severe exacerbation (p < 0.001; primary endpoint), resulting in a 45-47% lower exacerbation risk versus bud/form + SABA (hazard ratio, 0.55; 95% confidence interval, 0.44, 0.67) or bud + SABA (hazard ratio, 0.53; 95% confidence interval 0.43, 0.65). Bud/form maintenance + relief also prolonged the time to the first, second, and third exacerbation requiring medical intervention (p < 0.001), reduced severe exacerbation rate, and improved symptoms, awakenings, and lung function compared with both fixed dosing regimens.
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Citations
A randomized open-label trial on the use of budesonide/formoterol (Symbicort®) as an alternative reliever medication for mild to moderate asthmatic attacks.
TL;DR: This study suggests that there is no statistical difference between using Symbicort® vs. nebulized salbutamol as the reliever for the first 15 min post-intervention, with none reporting "no change" or getting worse.
Asthma maintenance and reliever therapy: Should this be the standard of care?
TL;DR: Budesonide/formoterol as a single combination maintenance and reliever inhaler is effective in reducing asthma exacerbation risk, requires a lower maintenance dose of ICS, and results in a simplified approach to asthma management.
Safety of regular use of long-acting beta agonists as monotherapy or added to inhaled corticosteroids in asthma. A systematic review
TL;DR: This review reinforced the international recommendations in terms of the use of LABA remains the preferred add-on therapy to ICS for patients whose disease cannot adequately controlled with ICS, and that LABA cannot be prescribed as a monotherapy.
Budesonide/formoterol in the treatment of asthma
TL;DR: The benefits of this medication clearly outweigh any possible small increased risk and concerns regarding safety of long-acting β-agonists have not been confirmed in studies of the budesonide/formoterol combination inhaler.
References
Lung volumes and forced ventilatory flows
TL;DR: Assessing the total lung capacity is indispensable in establishing a restrictive ventilatory defect or in diagnosing abnormal lung distensibility, as may occur in patients …
5.4K
•Journal Article
Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society.
4.3K
Effect of inhaled formoterol and budesonide on exacerbations of asthma. Formoterol and Corticosteroids Establishing Therapy (FACET) International Study Group
Romain Pauwels,Claes-Göran Löfdahl,Dirkje S. Postma,Anne E. Tattersfield,Paul M. O'Byrne,Peter J. Barnes,A Ullman +6 more
TL;DR: In patients who have persistent symptoms of asthma despite treatment with inhaled glucocorticoids, the addition of formoterol to budesonid therapy or the use of a higher dose of budesonide may be beneficial.
1.5K
Clinical management of asthma in 1999: the Asthma Insights and Reality in Europe (AIRE) study
TL;DR: In this article, the authors assessed the current levels of asthma control as reported by patients, which partly reflect the extent to which guideline recommendations are implemented, and found that patients' perception of asthma management is different from their actual asthma control.
1.1K