- Budesonide-formoterol as-needed reliever therapy is associated with 31% fewer severe exacerbations per patient per year than maintenance budesonide plus as-needed terbutaline in primary care patients with mild to moderate asthma.
Why this matters
- Many patients in primary care are poorly adherent with maintenance medication because of the intermittent nature of symptoms.
- Formoterol is a fast-onset, long-acting β-adrenergic agonist.
- 52-week, open-label, parallel-group, multicentre superiority randomised controlled trial (n=885) of as-needed budesonide 200 μg/formoterol 6 μg Turbuhaler or maintenance budesonide 200 μg Turbuhaler plus as-needed terbutaline 250 μg Turbuhaler for mild to moderate asthma.
- Primary outcome was the number of severe exacerbations per patient per year in the intent-to-treat group; exacerbations were defined as systemic corticosteroid use for ≥3 days or admission to hospital or emergency department to receive systemic corticosteroids.
- Funding: Health Research Council of New Zealand.
- The budesonide-formoterol group had 31% fewer severe exacerbations per patient per year (0.119 vs 0.172 in the maintenance budesonide plus terbutaline group; relative rate 0.69; P=.049).
- Groups had similar rates of the most common adverse event, nasopharyngitis (35% vs 32%, respectively).
- Open-label design.