Difference in time-course of improvement in asthma control measures between budesonide and budesonide/formoterol.

Kazuto Matsunaga, Hiroki Kawabata, Tsunahiko Hirano, Hisatoshi Sugiura, Yoshiaki Minakata, Masakazu Ichinose

Third Department of Internal Medicine, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama 641-8509, Japan. kazmatsu@wakayama-med.ac.jp

Pulmonary pharmacology & therapeutics 2013 Apr

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Combinations of inhaled corticosteroids (ICS) and inhaled long-acting beta(2)-agonists (LABA) have become widely used for the initiation of maintenance treatment for asthma. However, it has not been fully elucidated whether ICS/LABA alters the time-course of different control outcome measures in steroid-naive patients with asthma compared to the treatment with ICS alone. We compared the time-response in Asthma Control Questionnaire (ACQ), forced expiratory volume in 1 s (FEV1), exhaled nitric oxide fraction (FE(NO)), and airway responsiveness to methacholine (PD(200)) between budesonide (BUD) and budesonide/formoterol (BUD/FM). BUD/FM therapy significantly improved the ACQ score at week 2 and week 4 (p < 0.01 and p < 0.05), and increased FEV1 and the methacholine threshold at week 8 and week 24 (all p < 0.05) compared to BUD alone. A logistic function model showed that the BUD/FM combination significantly improved ACQ, FEV1, FE(NO) and PD(200) at a faster rate than BUD over 24 weeks (p < 0.001 for ACQ, FEV1, PD(200), and p < 0.05 for FE(NO), z-test). A significant variance in the time-response was also found in the outcomes of the two treatment groups (FE(NO) and ACQ > FEV1 and PD(200), p < 0.001, z-test). The present study provides evidence that ICS/LABA combination therapy results in a more rapid improvement in asthma symptoms, lung function, and airway inflammation compared to ICS monotherapy in steroid-naive patients with asthma. Copyright © 2012 Elsevier Ltd. All rights reserved.

Citation

Kazuto Matsunaga, Hiroki Kawabata, Tsunahiko Hirano, Hisatoshi Sugiura, Yoshiaki Minakata, Masakazu Ichinose. Difference in time-course of improvement in asthma control measures between budesonide and budesonide/formoterol. Pulmonary pharmacology & therapeutics. 2013 Apr;26(2):189-94