0
Clinical Investigations: ASTHMA |

Budesonide and Formoterol in a Single Inhaler Improves Asthma Control Compared With Increasing the Dose of Corticosteroid in Adults With Mild-to-Moderate Asthma*

Umesh G. Lalloo; Jóseph Malolepszy; Dezsó Kozma; Kamil Krofta; Jaro Ankerst; Bjørn Johansen; Neil C. Thomson
Author and Funding Information

*From the Nelson R. Mandela School of Medicine (Dr. Lalloo), University of Natal, Durban, South Africa; Medical Academy (Dr. Malolepszy), Wroclaw, Poland; Korányi National Institute of Tuberculosis and Pulmonology (Dr. Kozma), Budapest, Hungary; Thomayer Teaching Hospital (Dr. Krofta), Prague, Czech Republic; Lund University Hospital (Dr. Ankerst), Lund, Sweden; University Hospital (Dr. Johansen), Oslo, Norway; and Western Infirmary (Dr. Thomson), Glasgow, United Kingdom.

Correspondence to: Umesh G. Lalloo, MD, FCCP, Nelson R. Mandela School of Medicine, University of Natal, Private Bag 7, Congella 4013, Durban, South Africa; e-mail: lalloo@nu.ac.za



Chest. 2003;123(5):1480-1487. doi:10.1378/chest.123.5.1480
Text Size: A A A
Published online

Background: We evaluated the efficacy and safety of low-dose budesonide/formoterol, 80 μg/4.5 μg, bid in a single inhaler (Symbicort Turbuhaler; AstraZeneca; Lund, Sweden) compared with an increased dose of budesonide, 200 μg bid, in adult patients with mild-to-moderate asthma not fully controlled on low doses of inhaled corticosteroid alone.

Methods: All patients received budesonide, 100 μg bid, during a 2-week run-in period. At the end of the run-in phase, 467 patients with a mean FEV1 of 82% predicted received 12 weeks of treatment with budesonide/formoterol in a single inhaler or budesonide alone in a higher dose. Patients kept daily records of their morning and evening peak expiratory flow (PEF), nighttime and daytime symptom scores, and use of reliever medication.

Results: The increase in mean morning PEF—the primary efficacy measure—was significantly higher for budesonide/formoterol compared with budesonide alone (16.5 L/min vs 7.3 L/min, p = 0.002). Similarly, evening PEF was significantly greater in the budesonide/formoterol group (p < 0.001). In addition, the percentage of symptom-free days and asthma-control days (p = 0.007 and p = 0.002, respectively) were significantly improved in the budesonide/formoterol group. Budesonide/formoterol decreased the relative risk of an asthma exacerbation by 26% (p = 0.02) compared with budesonide alone. Adverse events were comparable between the two treatment groups.

Conclusion: This study shows that in adult patients whose mild-to-moderate asthma is not fully controlled on low doses of inhaled corticosteroids, single-inhaler therapy with budesonide and formoterol provides greater improvements in asthma control than increasing the maintenance dose of inhaled corticosteroid.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Guidelines
Long-term management of asthma.
Finnish Medical Society Duodecim | 1/11/2008
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543