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Therapeutics
Maintenance plus as needed budesonide plus formoterol was better than fixed dose for severe exacerbations in asthma

https://doi.org/10.1136/ebm.10.4.116

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    O’Byrne PM, Bisgaard H, Godard PP, et al. Budesonide/formoterol combination therapy as both maintenance and reliever medication in asthma. Am J Respir Crit Care Med 2005;171:129–36.
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 Q In patients with asthma, is budesonide (BUD) plus formoterol (FORM) (BUD+FORM) both for maintenance and symptom relief more effective than fixed dosing using BUD+FORM plus a short acting β2 agonist (SABA) or a 4 fold higher dose of BUD plus SABA for reducing the rate of severe asthma exacerbations?

    Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Internal medicine ★★★★★★☆ Respirology ★★★★★★★

    METHODS

    Embedded ImageDesign:

    randomised controlled trial.

    Embedded ImageAllocation:

    concealed.*

    Embedded ImageBlinding:

    blinded (patients and healthcare providers).*

    Embedded ImageFollow up period:

    1 year.

    Embedded ImageSetting:

    246 centers in 22 countries

    Embedded ImagePatients:

    2760 outpatients 4–80 years of age (mean age 36 y, 55% female; 12% children 4–11 y of age) with asthma who were using inhaled corticosteroids.

    Embedded ImageIntervention:

    BUD+FORM (budesonide, 80 μg, plus formoterol, 4.5 μg) both for maintenance and as needed (BUD+FORM for both, n = 925), BUD+FORM for maintenance plus terbutaline, 0.4 …

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    Footnotes

    • ↵* See glossary.

    • For correspondence: Dr P M O’Byrne, St Joseph’s Hospital, Hamilton, Ontario, Canada. obyrnepmcmaster.ca

    • Source of funding: AstraZeneca R&D, Lund, Sweden.