SELECTED ARTICLES FROM THE RECENT LITERATURE 2005
8/16/05
Adjustable budesonide/formoterol dosing in persistent asthma
Summary
Background - Treatment with a combination of fluticasone and salmeterol, inhaled corticosteroid (ICS) and long acting beta agonist (LABA) agents respectively, has been shown to control persistent asthma (PA) at about 50% of the fluticasone dose than when this ICS was used alone. Budesonide/formoterol (Bud/Form) is another ICS/LABA combination agent more recently introduced for the treatment of PA.
Findings - Pohl et al of the Gremmenstein Hospital in Austria carried out a randomized, double-blind comparison of a Bud/Form combination starting with 640/18 microg daily vs Bud alone, starting with 1280 microg/day in 133 adults with PA. The dosages of both medications were then adjusted over a 20 week period depending on patient-reported symptoms.
The control of asthma symptoms and requirements for rescue medications were not significantly different in patients treated with 1) The Bud/Form combination or 2) Bud alone. However, the quality of life levels were better in those treated with Bud/Form (p<0.05). Also, the median daily dose of Bud required to maintain adequate asthma control was significantly lower in those treated with Bud/Form than in those treated with Bud alone (448 vs 1152 microg, p=0.02).
Reference
Respir Med 2005; June 7 E pub.
Editor's Comments
These findings are fairly similar to that observed in previous comparisons of fluticasone/salmeterol vs fluticasone alone with 50% less ICS needed when used in combination therapy. Form may have an advantage over salmeterol in having a more rapid onset of bronchodilating action, as fast as that of albuterol. A recent report (reviewed in this Current Literature section) found that Bud/Form was effective as rescue as well as maintenance therapy in PA.
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