Budesonide-Formoterol Used As Needed Beneficial in Mild Asthma
THURSDAY, May 17, 2018 -- Inhaled combined budesonide-formoterol used as needed is beneficial for mild asthma, according to two studies published in the May 17 issue of the New England Journal of Medicine.
Paul M. O'Byrne, from McMaster University in Hamilton, Canada, and colleagues conducted a 52-week trial involving patients aged 12 years or older with mild asthma who were randomized to twice-daily placebo plus terbutaline used as needed (terbutaline, 1,277 patients), twice-daily placebo plus budesonide-formoterol used as needed (budesonide-formoterol, 1,277 patients), or twice-daily budesonide plus terbutaline used as needed (budesonide maintenance, 1,282 patients). The researchers found that budesonide-formoterol was superior to terbutaline (34.4 versus 31.1 percent of weeks; odds ratio, 1.14) with respect to the mean percentage of weeks with well-controlled asthma per patient and was inferior to budesonide maintenance therapy (34.4 versus 44.4 percent; odds ratio, 0.64).
Eric D. Bateman, M.D., from the University of Cape Town in South Africa, and colleagues randomized patients aged 12 years or older with mild asthma who were eligible for regular inhaled glucocorticoids to receive twice-daily placebo plus budesonide-formoterol used as needed (2,089 patients) or budesonide maintenance therapy plus terbutaline as needed (2,087 patients). The researchers found that budesonide-formoterol used as needed was non-inferior to budesonide maintenance for severe exacerbations, with annualized rates of severe exacerbations of 0.11 and 0.12, respectively (rate ratio, 0.97; upper one-sided 95 percent confidence limit, 1.16).
"These two trials show persuasively that treatment with budesonide-formoterol on an as-needed basis prevented the most serious outcomes of poorly controlled asthma," writes the author of an accompanying editorial.
AstraZeneca, which manufactures budesonide-formoterol, funded both studies.
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Posted: May 2018