Overall asthma control achieved with budesonide/formoterol maintenance and reliever therapy for patients on different treatment steps

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dc.contributor.authorBateman, Eric D
dc.contributor.authorHarrison, Tim W
dc.contributor.authorQuirce, Santiago
dc.contributor.authorReddel, Helen K
dc.contributor.authorBuhl, Roland
dc.contributor.authorHumbert, Marc
dc.contributor.authorJenkins, Christine R
dc.contributor.authorPeterson, Stefan
dc.contributor.authorÖstlund, Ollie
dc.contributor.authorO'Byrne, Paul M
dc.contributor.authorSears, Malcolm R
dc.contributor.authorEriksson, Göran S
dc.date.accessioned2017-11-20T14:13:29Z
dc.date.available2017-11-20T14:13:29Z
dc.date.issued2011-12-01
dc.date.updated2016-10-05T18:05:14Z
dc.description.abstractBackground: Adjusting medication for uncontrolled asthma involves selecting one of several options from the same or a higher treatment step outlined in asthma guidelines. We examined the relative benefit of introducing budesonide/formoterol (BUD/FORM) maintenance and reliever therapy (Symbicort SMART® Turbuhaler®) in patients previously prescribed treatments from Global Initiative for Asthma (GINA) Steps 2, 3 or 4. Methods: This is a post hoc analysis of the results of five large clinical trials (>12000 patients) comparing BUD/ FORM maintenance and reliever therapy with other treatments categorised by treatment step at study entry. Both current clinical asthma control during the last week of treatment and exacerbations during the study were examined. Results: At each GINA treatment step, 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 inhaled corticosteroid/long-acting b2-agonist (ICS/LABA) (plus short-acting b2-agonist [SABA] as reliever), and rates of exacerbations were lower at all treatment steps in BUD/FORM maintenance and reliever therapy versus same maintenance dose ICS/LABA (P < 0.01) and at treatment Step 4 versus higher maintenance dose ICS/LABA (P < 0.001). BUD/FORM maintenance and reliever therapy also achieved significantly higher rates of current clinical control and significantly lower exacerbation rates at most treatment steps compared with a higher maintenance dose ICS + SABA (Steps 2-4 for control and Steps 3 and 4 for exacerbations). With all treatments, the proportion of patients achieving current clinical control was lower with increasing treatment steps. Conclusions: BUD/FORM maintenance and reliever therapy may be a preferable option for patients on Steps 2 to 4 of asthma guidelines requiring a more effective treatment and, compared with other fixed dose alternatives, is most effective in the higher treatment steps.
dc.identifier.apacitationBateman, E. D., Harrison, T. W., Quirce, S., Reddel, H. K., Buhl, R., Humbert, M., ... Eriksson, G. S. (2011). Overall asthma control achieved with budesonide/formoterol maintenance and reliever therapy for patients on different treatment steps. <i>. Respiratory Research</i>, http://hdl.handle.net/11427/26407en_ZA
dc.identifier.chicagocitationBateman, Eric D, Tim W Harrison, Santiago Quirce, Helen K Reddel, Roland Buhl, Marc Humbert, Christine R Jenkins, et al "Overall asthma control achieved with budesonide/formoterol maintenance and reliever therapy for patients on different treatment steps." <i>. Respiratory Research</i> (2011) http://hdl.handle.net/11427/26407en_ZA
dc.identifier.citationRespiratory Research. 2011 Dec 01;12(1):38
dc.identifier.ris TY - Journal Article AU - Bateman, Eric D AU - Harrison, Tim W AU - Quirce, Santiago AU - Reddel, Helen K AU - Buhl, Roland AU - Humbert, Marc AU - Jenkins, Christine R AU - Peterson, Stefan AU - Östlund, Ollie AU - O'Byrne, Paul M AU - Sears, Malcolm R AU - Eriksson, Göran S AB - Background: Adjusting medication for uncontrolled asthma involves selecting one of several options from the same or a higher treatment step outlined in asthma guidelines. We examined the relative benefit of introducing budesonide/formoterol (BUD/FORM) maintenance and reliever therapy (Symbicort SMART® Turbuhaler®) in patients previously prescribed treatments from Global Initiative for Asthma (GINA) Steps 2, 3 or 4. Methods: This is a post hoc analysis of the results of five large clinical trials (>12000 patients) comparing BUD/ FORM maintenance and reliever therapy with other treatments categorised by treatment step at study entry. Both current clinical asthma control during the last week of treatment and exacerbations during the study were examined. Results: At each GINA treatment step, 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 inhaled corticosteroid/long-acting b2-agonist (ICS/LABA) (plus short-acting b2-agonist [SABA] as reliever), and rates of exacerbations were lower at all treatment steps in BUD/FORM maintenance and reliever therapy versus same maintenance dose ICS/LABA (P < 0.01) and at treatment Step 4 versus higher maintenance dose ICS/LABA (P < 0.001). BUD/FORM maintenance and reliever therapy also achieved significantly higher rates of current clinical control and significantly lower exacerbation rates at most treatment steps compared with a higher maintenance dose ICS + SABA (Steps 2-4 for control and Steps 3 and 4 for exacerbations). With all treatments, the proportion of patients achieving current clinical control was lower with increasing treatment steps. Conclusions: BUD/FORM maintenance and reliever therapy may be a preferable option for patients on Steps 2 to 4 of asthma guidelines requiring a more effective treatment and, compared with other fixed dose alternatives, is most effective in the higher treatment steps. DA - 2011-12-01 DB - OpenUCT DO - 10.1186/1465-9921-12-38 DP - University of Cape Town J1 - . Respiratory Research LK - https://open.uct.ac.za PB - University of Cape Town PY - 2011 T1 - Overall asthma control achieved with budesonide/formoterol maintenance and reliever therapy for patients on different treatment steps TI - Overall asthma control achieved with budesonide/formoterol maintenance and reliever therapy for patients on different treatment steps UR - http://hdl.handle.net/11427/26407 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/1465-9921-12-38
dc.identifier.urihttp://hdl.handle.net/11427/26407
dc.identifier.vancouvercitationBateman ED, Harrison TW, Quirce S, Reddel HK, Buhl R, Humbert M, et al. Overall asthma control achieved with budesonide/formoterol maintenance and reliever therapy for patients on different treatment steps. . Respiratory Research. 2011; http://hdl.handle.net/11427/26407.en_ZA
dc.language.rfc3066en
dc.publisherBioMed Central
dc.publisher.departmentDivision of Pulmonologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderBateman et al; licensee BioMed Central Ltd.
dc.source. Respiratory Research
dc.source.urihttps://respiratory-research.biomedcentral.com/
dc.titleOverall asthma control achieved with budesonide/formoterol maintenance and reliever therapy for patients on different treatment steps
dc.typeJournal Article
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