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Budesonide, formoterol regular therapy better for moderate asthma

Regular use of budesonide and formoterol in combination for treatment of moderate asthma may be better than treatment on an as-needed basis, according to recent study results.

“Our results show that as-needed budesonide and formoterol is inferior to regular budesonide and formoterol plus as-needed terbutaline in preventing treatment failure and in maintaining asthma control,” Alberto Papi, MD, of the department of respiratory medicine at the University of Ferrara in Italy, and colleagues wrote.

Papi and colleagues conducted a noninferiority, randomized, placebo-controlled trial with 866 patients with moderate asthma from April 2009 to March 2012. Participants were divided into two treatment groups: as-needed twice-daily 160 µg budesonide and 4.5 µg formoterol therapy, and regular twice-daily 160 µg budesonide and 4.5 µg formoterol therapy with 500 µg terbutaline as required.

Shorter time elapsed before 25% of participants using the as-needed therapy experienced at least one treatment failure compared with participants using regular therapy (11.86 weeks vs. 28 weeks; P = .0011). Treatment failure occurred most often due to nocturnal awakenings.

However, the researchers wrote that budgetary restrictions limited their study.

“Owing to the limited budget, monitoring of the [centers] was mainly done via teleconference or the Internet and not through direct site visits as is usually done in pharmaceutically sponsored randomized clinical trials,” the researchers wrote. – by Ryan McDonald

Disclosure: Papi reports receiving grants from Agenzia Italiana del Farmaco during the study; and grants, personal fees, and nonfinancial support from AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, GlaxoSmithKline, Merck Sharp & Dohme, Menarini, Mundipharma, Novartis, Pfizer, Takeda and Zambon. See the full study for a list of all other authors’ relevant financial disclosures.