Difference in time-course of improvement in asthma control measures between budesonide and budesonide/formoterol |
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| Authors: | Kazuto Matsunaga Hiroki Kawabata Tsunahiko Hirano Hisatoshi Sugiura Yoshiaki Minakata Masakazu Ichinose |
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| Affiliation: | 1. Third Department of Internal Medicine, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama 641-8509, Japan;2. Department of Respiratory Medicine, Tohoku University, Graduate School of Medicine, Sendai, Japan;1. Third Department of Internal Medicine, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama 641-8509, Japan;2. Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan;1. Vascular Biology Center, Georgia Health Sciences University, 1459 Laney Walker Blvd, CB3210B, Augusta, GA 30912, USA;2. Department of Pediatrics, University of California, San Francisco, CA 94143, USA;3. The Cardiovascular Research Institute, University of California, San Francisco, CA 94143, USA;1. Clinical Research Institute of Southern Oregon, 3860 Crater Lake Avenue, Medford, OR 97504, USA;2. GlaxoSmithKline, Research Triangle Park, NC, USA;3. Formerly GlaxoSmithKline, Stockley Park, London, UK;4. University of Omaha, Nebraska, OH, USA;5. Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona and FISIB, CIBERES, Mallorca, Spain;6. Respiratory Medicine, Barts and The London NHS Trust, London, UK;1. Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan;2. Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan;1. Department of Urology, University of Patras, Patras, Greece;2. Department of Obstetrics and Gynecology, University of Patras, Greece;3. Department of Urology, University of Leipzig, Leipzig, Germany;4. Department of Urology, University of Tübingen, Tübingen, Germany |
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| Abstract: | Combinations of inhaled corticosteroids (ICS) and inhaled long-acting beta2-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 (FENO), and airway responsiveness to methacholine (PD200) 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, FENO and PD200 at a faster rate than BUD over 24 weeks (p < 0.001 for ACQ, FEV1, PD200, and p < 0.05 for FENO, z-test). A significant variance in the time-response was also found in the outcomes of the two treatment groups (FENO and ACQ > FEV1 and PD200, 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. |
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