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 novel endpoint for exacerbations in asthma to accelerate clinical development: a post-hoc analysis of randomised controlled trials
Anne L. Fuhlbrigge,Thomas Bengtsson,Stefan Peterson,Alexandra Jauhiainen,Göran Eriksson,Carla A. Da Silva,Anthony Johnson,Tariq Sethi,Nicholas Locantore,Ruth Tal-Singer,Malin Fagerås +10 more
TL;DR: The ability of CompEx to increase event frequencies, preserve treatment effect, and reduce the number of patients needed allows design of shorter trials that require fewer patients than studies of severe exacerbations, while preserving the ability to show a treatment effect compared with severe exacerbation.
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Risk of mortality associated with formoterol: a systematic review and meta-analysis.
TL;DR: It is concluded that there was insufficient power to determine whether formoterol increases the risk of mortality, and point estimates of a 2.0- to 3.2-fold increased risk of asthma death are not reassuring and add weight to evidence that LABA use in certain circumstances may increase therisk of asthma mortality.
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Combination formoterol and inhaled steroid versus beta2-agonist as relief medication for chronic asthma in adults and children
TL;DR: Assessment of the efficacy and safety of combined inhalers containing both formoterol and an inhaled corticosteroid when used for reliever therapy in adults and children with chronic asthma found no significant difference in annual growth in children using budesonide/formoterol reliever in comparison to terbutaline.
Peak flow monitoring in clinical practice and clinical asthma trials
TL;DR: Current use of PEF data is limited by the burden of monitoring and the continuing use of interpretative tools that were originally developed for their practical feasibility rather than their clinical validity, and these problems may be improved by giving attention to methods for recording, displaying and analysingPEF data.
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Glucocorticoids rapidly activate cAMP production via Gαs to initiate non-genomic signaling that contributes to one-third of their canonical genomic effects.
Francisco J. Nuñez,Timothy B. Johnstone,Maia L. Corpuz,Austin G. Kazarian,Nicole N. Mohajer,Omar Tliba,Reynold A. Panettieri,Cynthia J. Koziol-White,Moom R. Roosan,Rennolds S. Ostrom +9 more
TL;DR: It is found that prednisone, fluticasone, budesonide, and progesterone each increased cAMP levels within 3 minutes without phosphodiesterase inhibitors by measuring real‐time cAMP dynamics using the cAMP difference detector in situ assay in a variety of immortalized cell lines and primary human airway smooth muscle (HASM) cells.
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