Budesonide/formoterol for maintenance and relief in uncontrolled asthma vs. high-dose salmeterol/fluticasone

136Citations
Citations of this article
108Readers
Mendeley users who have this article in their library.

Abstract

Background: Budesonide/formoterol maintenance and reliever therapy (Symbicort SMART®) improves asthma control compared with fixed-dose inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) regimens, but its efficacy has not been assessed in comparison with sustained high-dose salmeterol/fluticasone (Seretide™) plus a short-acting β2-agonist (SABA). Methods: Patients (N=2309) with symptomatic asthma (aged ≥12 years; forced expiratory volume in 1 s ≥50% predicted), who had experienced an asthma exacerbation in the previous year, were randomised to receive budesonide/formoterol 160/4.5 μg two inhalations twice daily and as needed, or one inhalation of salmeterol/fluticasone 50/500 μg twice daily plus terbutaline as needed, for 6 months. Results: Time to first severe exacerbation, the pre-specified primary outcome, was not significantly prolonged (risk ratio 0.82; 95% confidence interval 0.63, 1.05). Budesonide/formoterol maintenance and reliever therapy reduced total exacerbations from 31 to 25 events/100 patients/year (P=0.039), and exacerbations requiring hospitalisation/emergency room (ER) treatment from 13 to 9 events/100 patients/year (P=0.046). The treatments showed no difference in measures of lung function or asthma symptoms. The mean dose of ICS received was lower using budesonide/formoterol maintenance and reliever therapy (792 μg/day budesonide [1238 μg/day beclomethasone dipropionate (BDP) equivalent] versus 1000 μg/day fluticasone [2000 μg/day BDP equivalent] with salmeterol/fluticasone therapy; P<0.0001). Both treatments were well tolerated. Conclusion: In the treatment of uncontrolled asthma, budesonide/formoterol maintenance and reliever therapy reduces the incidence of severe asthma exacerbations and hospitalisation/ER treatment with similar daily symptom control compared with sustained high-dose salmeterol/fluticasone plus SABA. This benefit is achieved with substantially less ICS exposure. © 2007.

Cite

CITATION STYLE

APA

Bousquet, J., Boulet, L. P., Peters, M. J., Magnussen, H., Quiralte, J., Martinez-Aguilar, N. E., & Carlsheimer, Å. (2007). Budesonide/formoterol for maintenance and relief in uncontrolled asthma vs. high-dose salmeterol/fluticasone. Respiratory Medicine, 101(12), 2437–2446. https://doi.org/10.1016/j.rmed.2007.07.014

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free