Journal ArticleDOI
Low dose inhaled budesonide and formoterol in mild persistent asthma: the OPTIMA randomized trial.
Paul M. O'Byrne,Peter J. Barnes,Roberto Rodriguez-Roisin,Eva Runnerstrom,Thomas Sandström,Klas Svensson,Anne E. Tattersfield +6 more
TLDR
Low dose inhaled budesonide alone reduced severe exacerbations and improved asthma control, and in patients already receiving inhaled corticosteroid, adding formoterol was more effective than doubling the cortiosteroid dose.Abstract:
The optimal treatment for mild asthma is uncertain. We assessed the effects of adding a long-acting inhaled beta-agonist, formoterol, to low doses of an inhaled corticosteroid, budesonide, for 1 yr in subjects with mild asthma, receiving no or only a small dose of inhaled corticosteroid. The 698 corticosteroid free patients (Group A) were assigned to twice daily treatment with 100 microg budesonide, 100 microg budesonide plus 4.5 microg formoterol, or placebo. The 1,272 corticosteroid-treated patients (Group B) were assigned to twice daily treatment with 100 microg budesonide, 100 microg budesonide plus 4.5 microg formoterol, 200 microg budesonide, or 200 microg budesonide plus 4.5 microg formoterol. The main outcome variables were time to the first severe asthma exacerbation and poorly controlled asthma days. In Group A, budesonide alone reduced the risk for severe exacerbations by 60% and poorly controlled days by 48%; adding formoterol increased lung function with no change in other end points. By contrast, in Group B, adding formoterol reduced the risk for the first severe exacerbation and for poorly controlled days by 43 and 30%, respectively. Thus, in corticosteroid-free patients, low dose inhaled budesonide alone reduced severe exacerbations and improved asthma control, and in patients already receiving inhaled corticosteroid, adding formoterol was more effective than doubling the corticosteroid dose.read more
Citations
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Journal ArticleDOI
Global strategy for asthma management and prevention: GINA executive summary.
Eric D. Bateman,Suzanne S. Hurd,Peter J. Barnes,Jean Bousquet,Jeffrey M. Drazen,JM FitzGerald,Peter G. Gibson,K. Ohta,Paul M. O'Byrne,Søren Pedersen,Emilio Pizzichini,Sean D. Sullivan,Sally E. Wenzel,Heather J. Zar +13 more
TL;DR: It is reasonable to expect that in most patients with asthma, control of the disease can and should be achieved and maintained, and the Global Initiative for Asthma recommends a change in approach to asthma management, with asthma control, rather than asthma severity, being the focus of treatment decisions.
Journal ArticleDOI
An official American Thoracic Society/European Respiratory Society statement: asthma control and exacerbations: standardizing endpoints for clinical asthma trials and clinical practice.
Helen K. Reddel,D. Robin Taylor,Eric D. Bateman,Louis-Philippe Boulet,Homer A. Boushey,William W. Busse,Thomas B. Casale,Pascal Chanez,Paul L. Enright,Peter G. Gibson,Johan C. de Jongste,Huib A. M. Kerstjens,Stephen C. Lazarus,Mark L Levy,Paul M. O'Byrne,Martyn R Partridge,Ian D. Pavord,Malcolm R. Sears,Peter J. Sterk,Stuart W. Stoloff,Sean D. Sullivan,Stanley J. Szefler,Mike Thomas,Sally E. Wenzel +23 more
TL;DR: New definitions for asthma control, severity, and exacerbations are developed, based on current treatment principles and clinical and research relevance, to provide a basis for a multicomponent assessment of asthma by clinicians, researchers, and other relevant groups in the design, conduct, and evaluation of clinical trials, and in clinical practice.
Journal ArticleDOI
Can guideline-defined asthma control be achieved? The Gaining Optimal Asthma ControL study.
Eric D. Bateman,Homer A. Boushey,Jean Bousquet,William W. Busse,T. Clark,Romain Pauwels,Søren Pedersen +6 more
TL;DR: A 1-year, randomized, stratified, double-blind, parallel-group study of 3,421 patients with uncontrolled asthma, confirming that the goal of guideline-derived asthma control was achieved in a majority of the patients.
Journal ArticleDOI
British guideline on the management of asthma: A national clinical guideline
Graham Douglas,Bernard Higgins,Neil Barnes,Anne Boyter,Sherwood Burge,Christopher J Cates,Gary Connett,Jon Couriel,Paul Cullinan,Sheila Edwards,Erica Evans,Monica Fletcher,Christopher E.M. Griffiths,Liam Heaney,Michele Hilton Boon,Steve Holmes,Ruth McArthur,C Nelson-Piercy,Martyn R Partridge,James Y. Paton,Ian D. Pavord,Elaine Carnegie,Hilary Pinnock,Safia Qureshi,Colin F. Robertson,Michael D. Shields,John O. Warner,John H. White +27 more
TL;DR: These guidelines have been replaced by British Guideline on the Management of Asthma.
Journal ArticleDOI
Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease
W. Szafranski,Alberto Cukier,A. Ramirez,G. Menga,R. Sansores,S. Nahabedian,S. Peterson,H. Olsson +7 more
TL;DR: A role for budesonide/formoterol in the long-term management of moderate-to-severe chronic obstructive pulmonary disease is suggested and all treatments were well tolerated.
References
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Journal ArticleDOI
Effect of inhaled formoterol and budesonide on exacerbations of asthma. Formoterol and Corticosteroids Establishing Therapy (FACET) International Study Group
Romain Pauwels,Claes-Göran Löfdahl,Dirkje S. Postma,Anne E. Tattersfield,Paul M. O'Byrne,Peter J. Barnes,A Ullman +6 more
TL;DR: In patients who have persistent symptoms of asthma despite treatment with inhaled glucocorticoids, the addition of formoterol to budesonid therapy or the use of a higher dose of budesonide may be beneficial.
Journal ArticleDOI
Regular inhaled beta-agonist treatment in bronchial asthma
Malcolm R. Sears,D R Taylor,Cristin G. Print,D C Lake,Q Q Li,E M Flannery,D M Yates,M K Lucas,G. P. Herbison +8 more
TL;DR: Regular inhalation of a beta-sympathomimetic agent was associated with deterioration of asthma control in the majority of subjects, suggesting that the trends to use of regular, higher doses or longer-acting inhaled beta-SympathomIMetic treatment may be an important causal factor in the worldwide increase in morbidity from asthma.
Journal ArticleDOI
Added salmeterol versus higher-dose corticosteroid in asthma patients with symptoms on existing inhaled corticosteroid
TL;DR: There was no significant difference between the groups in adverse effects or exacerbations of asthma, indicating that in this group of patients regular beta 2-agonist therapy was not associated with any risk of deteriorating asthma control over 6 months.