Budesonide/formoterol maintenance and reliever therapy in asthma control: Acute, dose‐related effects and real‐life effectiveness. Issue 2 (3rd November 2014)

• Record Type: Journal Article
• Authors: Lin, Ching‐Hsiung; Hsu, Jeng‐Yuan; Hsiao, Yi‐Han; Tseng, Ching‐Min; Su, Vincent Yi‐Fong; Chen, Yu‐Hsuan; Yang, Sheau‐Ning; Lee, Yu‐Chin; Su, Kang‐Cheng; Perng, Diahn‐Warng
• Is Part Of: Respirology. Volume 20:Issue 2(2015)
• Page Start: 264
• Page End: 272
• Publication Date: 2014-11-03
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 612.2
• DOI: 10.1111/resp.12425
• Languages: English
• ISSNs: 1323-7799

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="resp12425-sec-0001" sec-type="section"> <title>Background and objective</title> <p>The efficacy of budesonide/formoterol maintenance and reliever therapy (BFMRT) in asthma control is well documented in large randomized controlled trials. However, the acute reliever effects and real‐life effectiveness are seldom reported.</p> </sec> <sec id="resp12425-sec-0002" sec-type="section"> <title>Methods</title> <p>This multicenter trial enrolled steroid‐naïve, symptomatic asthmatics with baseline exhaled nitric oxide (eNO) of ≥40 ppb. There were 120 eligible patients who were randomized and received a dose of inhaled budesonide/formoterol 320/9 μg (lower dose budesonide/formoterol), 640/18 μg (higher dose budesonide/formoterol (HDBF)), or terbutaline (TERB) 1 mg. Inflammatory cells and mediators in induced sputum, eNO and lung function were measured at baseline and 6 h (acute phase). Subsequently, all patients used BFMRT as real‐life practice for 24 weeks (maintenance phase).</p> </sec> <sec id="resp12425-sec-0003" sec-type="section"> <title>Results</title> <p>In the acute phase, the degree of post‐treatment reduction in total eosinophil counts, interleukin‐8 and matrix metalloproteinase‐9 in induced sputum were significantly greater in group HDBF (vs TERB, <italic>P</italic> < 0.05). The increase in forced expiratory volume in first second (FEV<sub>1</sub>) in group HDBF was significantly higher (vs LDBF and TERB, <italic>P</italic> < 0.05) 3 h after dosing. In the maintenance phase, significant improvement of asthma control (presented by eNO, FEV<sub>1</sub> and a five‐item asthma control questionnaire) in real‐life settings was observed at 4 weeks and sustained to the end of study. The rate of patients who followed scheduled visits declined over time (87% at week 4 and 42% at week 24).</p> </sec> <sec id="resp12425-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Budesonide/formoterol as reliever exerts acute, dose‐related anti‐inflammatory effects and FEV<sub>1</sub> improvement in symptomatic asthmatics. BFMRT is effective in asthma control. However, the decrease in long‐term follow‐up rate remains an issue to overcome in real‐life settings.</p> </sec> </abstract>