Budesonide/Formoterol combination therapy as both maintenance and reliever medication in asthma

Asthma control is improved by combining inhaled corticosteroids with long-acting beta(2)-agonists. However, fluctuating asthma control still occurs. We hypothesized that in patients receiving low maintenance dose budesonide/formoterol (bud/form), replacing short-acting beta(2)-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 (FEV(1) 60-100% predicted) received either terbutaline 0.4 mg as SABA with bud/form 80/4.5 mug twice a day (bud/form + SABA) or bud 320 mug twice a day (bud + SABA) or bud/form 80/4.5 mug twice a day with 80/4.5 mug 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.

Bisgaard, H. (author)
Godard, P. P. (author)
Pistolesi, M. (author)
Palmqvist, Mona,1957Gothenburg University,Göteborgs universitet,Institutionen för invärtesmedicin, Avdelningen för lungmedicin och allergologi,Institute of Internal Medicine, Dept of Respiratory Medicine/Allergology(Swepub:gu)xpamon (author)
Zhu, Y. (author)
Ekström, T. (author)
Bateman, E. D. (author)
Göteborgs universitetInstitutionen för invärtesmedicin, Avdelningen för lungmedicin och allergologi (creator_code:org_t)

By the author/editor: O'Byrne P, M.; Bisgaard, H.; Godard, P. P.; Pistolesi, M.; Palmqvist, Mona, ...; Zhu, Y.; show more...; Ekström, T.; Bateman, E. D.; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Respiratory Medi ...

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