MedWire News: A combination of budesonide/formoterol maintenance and reliever therapy in the same inhaler is more effective for improving key aspects of asthma control than physicians' choice of conventional best practice (CBP), study findings show.
Writing in the journal Respiratory Medicine, Pascal Demoly (Hôpital Arnaud de Villeneuve, Montpellier, France) and team explain: “Budesonide/formoterol maintenance and reliever therapy reduces asthma exacerbations and symptoms versus fixed-dose regimens plus short-acting β2-agonists (SABA) in double-blind trials.”
But they add: “Information is lacking regarding its effectiveness versus CBP.”
To investigate, the researchers assessed the pooled results from six 6-month, randomized, open-label studies involving a total of 7855 asthma patients aged at least 12 years.
The participants, who were symptomatic and taking inhaled corticosteroids (ICS) or stable/symptomatic and taking ICS/long-acting β2-agonists (LABA), were randomly assigned to receive budesonide/formoterol maintenance and reliever therapy twice a day or as needed, or physicians' choice of CBP, which included ICS alone or ICS and LABA with or without other approved agents.
Analysis revealed that patients taking the combination therapy experienced 15% fewer exacerbations, at 0.20 versus 0.24 exacerbations per patient per year, and used 27% fewer doses of ICS than those assigned to CBP.
Patients taking the combination therapy were also 29% more likely to have good asthma control, and 19% less likely to have uncontrolled disease, over the whole 6-month period than those assigned to CBP.
However, the team found no significant difference in time to first exacerbation between patients taking the combination therapy and those assigned to CBP.
Demoly and team conclude: “This large pooled analysis of six studies performed in a setting reflecting normal clinical practice showed that budesonide/formoterol maintenance and reliever therapy was well tolerated and was associated with a greater likelihood of improving overall asthma control, reducing exacerbations, and improving symptoms compared with physicians' free choice of maintenance therapy in accordance with local CBP.”
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