BUD/FORM maintenance and reliever therapy effective asthma control

Budesonide/Formoterol (BUD/FORM) maintenance and reliever therapy is an effective option for patients requiring treatment adjustments across Steps 2 to 4 of the Global Initiative for Asthma (GINA) guidelines, according to the results of a study published online, June 2 in Respiratory Research.

To examine the relative benefit of introducing BUD/FORM maintenance and reliever therapy in patients previously prescribed different treatment steps according to GINA, researchers analyzed the results of 5 clinical trials involving more than 12,000 patients that compared BUD/FORM maintenance and reliever therapy (Symbicort SMART Turbuhaler, AstraZeneca AB, Lund, Sweden) with comparator treatments in patients on GINA Steps 2, 3, or 4 at study entry.

Comparator treatments included: higher maintenance dose inhaled cortisteroid (ICS) (budesonide) plus short-acting beta-2 agonist (SABA) as needed; same maintenance dose ICS/long-acting beta-2 agonist (LABA) (BUD/FORM, Symbicort, AstraZeneca) plus SABA as needed; and higher maintenance dose ICS/LABA (BUD/FORM or salmeterol/fluticasone [Seretide, GlaxoSmithKline]) plus SABA as needed.

Results showed that the proportion of patients achieving target levels of current clinical control were similar or higher with BUD/FORM maintenance and reliever therapy compared with the same or a higher fixed maintenance dose of ICS/LABA plus SABA at each GINA treatment step. Rates of exacerbations were lower at all GINA treatment steps in BUD/FORM maintenance and reliever therapy versus same maintenance dose ICS/LABA and at treatment Step 4 versus higher maintenance dose ICS/LABA. Significantly higher rates of current clinical control (Steps 2-4) and significantly lower exacerbation rates (Steps 3 and 4) at most treatment steps were also achieved with BUD/FORM maintenance and reliever therapy compared with a higher maintenance dose ICS plus SABA.

“Increasing treatment in patients who require additional treatment medication involves selecting an option from among the treatments on the same or a higher step. Treatments are stratified on the basis of randomised trials comparing their efficacy in patients qualifying for that treatment step with due regard to their therapeutic index, that is, weighing up benefit and safety,” the authors wrote. Therefore, the results of this study provide useful information on the benefits and efficacy of using BUD/FORM maintenance and reliever therapy, they added.