Comparing the efficacy and safety of formoterol/budesonide pMDI versus its mono-components and other LABA/ICS in patients with asthma. (August 2020)

• Record Type: Journal Article
• Authors: Mukhopadhyay, Aniruddha; Waked, Mirna; Gogtay, Jaideep; Gaur, Vaibhav
• Is Part Of: Respiratory medicine. Volume 170(2020)
• Publication Date: 2020-08
• Subjects: Formoterol/budesonide -- Asthma -- Pressurised metered dose -- Inhalers; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2020.106055
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Introduction: Pressurised metered dose inhalers (pMDIs) are effective drug delivery devices prescribed in obstructive airway diseases due to their convenience, portability, ease of enabling multiple doses in a single formulation, and storage in any orientation. For the management of asthma, the fixed-dose combination of a long-acting β2 -agonist (LABA) and an inhaled corticosteroid (ICS) has been recommended by Global Initiative for Asthma guideline as a preferred treatment option for patients who are uncontrolled with only ICS doses. One of the available LABA/ICS combinations is the formoterol/budesonide (FB). Areas covered: This article systematically reviews the efficacy and safety of the FB pMDI compared with the FB dry powder inhaler (DPI), individual mono-components (formoterol and budesonide) or salmeterol/fluticasone (SF) combination in the treatment of asthma among paediatric and adult patients. PubMed was searched with the string: ''((Budesonide) AND Formoterol) AND ((((pMDI) OR MDI) OR Pressurised Metered-dose inhaler) OR Metered-dose inhaler)'', in ALL fields. Screening of all the articles was done till February 2020. We have included 24 articles from the total of 142 hits received. Conclusions: The FB pMDI is efficacious for the long-term management of asthma in patients 6 years of age and above. It has been shown to improve lung function and asthma control, and to reduce daytime and night-time symptoms, the number of rescue medication doses and asthma exacerbations. It also showed rapid onset of bronchodilatory effect with a dose–response relationship that allows patients to utilise it as a Single Maintenance And Reliever Therapy (SMART) regimen. Highlights: Formoterol/budesonide given via pMDI is an efficacious and well tolerated option for the long-term management of asthma. Formoterol/budesonide pMDI increases lung function and improves asthma control. It reduces day/night-time symptoms and asthma exacerbations. PMDI with a dose-counter potentially enhances patient compliance. Adding a non-static spacer with a valve to the FB pMDI may improve the drug deposition into the lungs.