SAN FRANCISCO — Patients with moderate to severe asthma experience fewer exacerbations and use adjunctive and rescue medications for shorter periods when taking combined budesonide and formoterol, compared with those taking budesonide alone, according to a poster presentation at the International Conference of the American Thoracic Society.
These results contradict three previous meta-analyses that failed to find pronounced reductions in asthma exacerbations in patients taking both long-acting β-2 agonists and inhaled steroids, compared with those taking inhaled steroids alone, wrote Dr. Christopher D. O'Brien of AstraZeneca and his coauthors. AstraZeneca, which manufactures combination budesonide and formoterol under the brand name Symbicort, supported the study.
Included in the multicenter randomized study were 708 adolescent and adult patients (mean age 40 years) who had received a diagnosis of asthma and reported consistent daily use of inhaled corticosteroids for at least 4 weeks before screening.
After a 2-week run-in period on budesonide alone (320 mcg twice daily), patients were randomized to receive a higher dose of budesonide alone (640 mcg twice daily), a high dose of budesonide and formoterol (640 mcg/18 mcg twice daily), or a low-dose of budesonide and formoterol (320 mcg/9 mcg twice daily).
Patients on both combined regimens experienced significantly fewer asthma exacerbations over the following 52 weeks. Those on the higher dose of budesonide and formoterol had a 45% reduction in exacerbations, and those on the lower dose had a 41% reduction, compared with patients taking budesonide alone.
Patients on both combined regimens also needed oral corticosteroids for fewer total days than did patients taking budesonide alone, with decreases of 51% for the higher combined dose and 42% for the lower combined dose. Conversely, there were no differences in the groups on several other measures of resource use, such as the number of days of hospitalization because of asthma, the number of emergency department visits, and number of unscheduled visits to a specialist or primary care physician.