A 7 months study included 658 asthmatic patients, with moderate to severe
asthma (ICS dose of approximately 750 µg/day, >70% of the patients used
long-acting ß2-agonists aged 12 years and above, Aalbers et al, 2004),
compared Symbicort adjustable maintenance dosing with Symbicort fixed
dosing and Seretide fixed dosing. Well-controlled asthma weeks*, exacerbations**, and as needed medication use were meassured in this study.
This study showed that:
- Well-controlled asthma weeks were similar between groups (primary variable)
- Patients on Symbicort adjustable maintenance dosing had a 40% lower rate of severe exacerbations, and lower use of reliever medication for symptom control, than patients on Seretide fixed dosing
- Symbicort adjustable maintenance dosing provides superior asthma control compared with Symbicort or Seretide fixed dosing
- This means that switching five patients from Seretide fixed dosing to Symbicort adjustable dosing would prevent one exacerbation per year
A 2- or 4 -fold temporary increase in maintenance dose, as is possible with Symbicort adjustable maintenance dosing, at an onset of worsening symptoms may prevent the development of an exacerbation.
Severe exacerbations and reliever use are lower with Symbicort adjustable maintenance dosing than with Seretide fixed dosing
*Definition: a week with no nighttime awakenings, no exacerbations, no change in asthma treatment due to adverse events and at least two of the following; asthma symptoms (score >1) on ≤2 days or ≤2 days of reliever use (maximum 4 occasions/week)
**Definition: Oral steroids ≥ 3 days, emergency visits or hospitalisation
The faster onset of effect of Symbicort compared to Seretide was confirmed
in a double-blind, placebo-controlled trial involving 30 patients with
asthma and reversible airflow obstruction (mean forced expiratory volume in 1
second [FEV1] 78% of predicted normal, mean reversibility after 500 µg
salbutamol 19%, Palmqvist et al, 2001), in which the onset of effect was
measured by FEV1 at 3 minutes and average FEV1 from 0-15 minutes:
Symbicort has a faster onset than Seretide
The rapid onset of effect of formoterol means that patients feel the benefit
of Symbicort almost immediately. This may help to increase patients' adherence
to their prescribed treatment, which ensures that patients receive the regular
dose of inhaled steroid necessary to control the underlying inflammation in asthma.
Palmqvist study summary
Aalbers study summary
|
