Formoterol as needed with or without budesonide in patients with intermittent asthma and raised NO levels in exhaled air: A SOMA study
2006 (English)In: European Respiratory Journal, ISSN 0903-1936, Vol. 28, no 4, 748-755 p.Article in journal (Refereed) Published
Patients with mild intermittent asthma sometimes show signs of inflammation, and guidelines suggesting bronchodilator therapy alone as needed may be questioned. The current study compared as-needed use of a rapid-acting β2-agonist with as-needed use of a β2-agonist and corticosterold combination as the only medication in asthma patients with intermittent symptoms. A total of 92 nonsmoking asthma patients (of 187 screened) using only an inhaled β2-agonist as needed (28 males, 64 females, mean age 37 yrs, mean forced expiratory volume in one second (FEV1) 101% predicted, mean reversibility 6.5% pred and fractional exhaled nitric oxide (FeNO) ≥20 parts per billion (ppb)) were randomised to treatment with formoterol (Oxis® Turbuhaler®) 4.5 μg as needed (n=47) or budesonide/formoterol (Symbicort® Turbuhaler®) 160/4.5 pg as needed (n=45) in a double-blind, parallel-group 24-week study. The primary variable of efficacy was change in FeNO. Baseline FeNO was 60 ppb and 59 ppb in the budesonide/formoterol and formoterol groups, respectively. Mean reductions in FeNO in the budesonide/formoterol and formoterol groups were 18.2 ppb and 2.8 ppb, respectively (95% confidence interval (CI) 7.5-23.5 ppb). The reduction in the budesonide/formoterol group occurred during the first 4 weeks of treatment and remained at this low level. Mean FEV1 increased by 1.8% pred normal value in the budesonide/formoterol group and decreased by 0.9% pred normal value in the formoterol group (95% Cl -4.7 - -0.7). In the budesonide/formoterol group, use of ≥4 inhalations-day-1 of study medication was seen on 21 treatment days compared with 74 in the formoterol group. In conclusion, as-needed use of an inhaled corticosteroid together with a rapid-acting bronchodilator may be more beneficial than a β2-agonist alone in patients with intermittent asthma and signs of airway inflammation. The long-term benefits are unknown. Copyright © ERS Journals Ltd 2006.
Place, publisher, year, edition, pages
2006. Vol. 28, no 4, 748-755 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-36345DOI: 10.1183/09031936.06.00128005Local ID: 31065OAI: oai:DiVA.org:liu-36345DiVA: diva2:257193