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| |  Budesonide/Formoterol Combination Improves Small-Airway Obstruction in Moderate to Severe Persistent Asthma Over 1 Year: Presented at AAAAI By Maggie Schwarz WASHINGTON, DC -- March 17, 2009 -- Patients with moderate to severe persistent asthma obtain benefits when they add a long-acting beta-agonist to inhaled corticosteroid (ICS) therapy, researchers reported here at the American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting. James G. Zangrilli, MD, AstraZeneca LP, Wilmington, Delaware, and colleagues assessed predose and 2-hour postdose measures of small-airway obstruction in adolescents and adults receiving twice-daily therapy with either budesonide/formoterol (BUD/FM) or budesonide alone, both by pressurised metered-dose inhaler (pMDI) for 1 year. They presented the results of their study on March 15. The efficacy and tolerability of the ICS budesonide and the fast-onset long-acting beta-agonist formoterol administered in 1 hydrofluoroalkane pMDI have been demonstrated in short-term (12-week) and long-term (52-week) studies of patients with persistent asthma previously receiving an ICS. But the long-term effect of BUD/FM pMDI on small-airway function has not been evaluated. For their study, Dr. Zangrilli and colleagues enrolled 708 patients aged at least 12 years. Spirometry testing consisted of a minimum of 3 forced expiratory manoeuvres in which the patient expired forcefully from total lung capacity to residual volume. Small-airway function was assessed via predose and 2-hour postdose forced midexpiratory flow rates (FEF25%-75%) obtained from the full expiratory-flow-volume-time curve. Improvements in predose FEF25%-75% were 12.6%, 11.6%, and 3.6% for the BUD/FM 640/18 mcg, BUD/FM 320/9 mcg, and BUD 640 mcg BID groups, respectively. Improvements in 2-hour postdose FEF25%-75% were 24.8%, 23.0%, and 5.9% for the 3 groups, respectively. Pre- and postdose improvements were observed at the first spirometry measure and were maintained for up to 1 year. Dr. Zangrilli and colleagues concluded that improvements in predose FEF25%-75% were observed in all treatment groups for up to 1 year without diminution. After a run-in period with BUD 320 mcg BID, patients receiving BUD/FM pMDI (640/18 mcg BID and 320/9 mcg BID) experienced greater improvements in predose and 2-hour postdose FEF25%-75% than those receiving BUD pMDI 640 mcg BID. These results extend the benefits of adding a long-acting bronchodilator to an inhaled corticosteroid to the small airways in patients with moderate to severe asthma. Funding for this study was provided by AstraZeneca.
[Presentation title: Predose and Postdose Forced Expiratory Flow Between 25% and 75% (FEF25%-75%) in Adolescents and Adults With Asthma Treated With Twice-Daily Budesonide/Formoterol Pressurized Metered-Dose Inhaler (BUD/FM pMDI) or BUD pMDI for 1 Year. Abstract 291]
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