AustralieFrV1, Main, Exploration, bibRecord, 006074

Overall asthma control achieved with budesonide/formoterol maintenance and reliever therapy for patients on different treatment steps

Identifieur interne : 006074 ( Main/Exploration ); précédent : 006073; suivant : 006075

Overall asthma control achieved with budesonide/formoterol maintenance and reliever therapy for patients on different treatment steps

Auteurs : Eric D. Bateman [Afrique du Sud] ; Tim W. Harrison [Royaume-Uni] ; Santiago Quirce [Espagne] ; Helen K. Reddel [Australie] ; Roland Buhl [Allemagne] ; Marc Humbert [France] ; Christine R. Jenkins [Australie] ; Stefan Peterson [Suède] ; Ollie Östlund [Suède] ; Paul M. O'Byrne [Canada] ; Malcolm R. Sears [Canada] ; Göran S. Eriksson [Suède]

Source :

Respiratory Research [ 1465-9921 ] ; 2011.

RBID : PMC:3082240

Abstract

Background

Adjusting medication for uncontrolled asthma involves selecting one of several options from the same or a higher treatment step outlined in asthma guidelines. We examined the relative benefit of introducing budesonide/formoterol (BUD/FORM) maintenance and reliever therapy (Symbicort SMART^®Turbuhaler^®) in patients previously prescribed treatments from Global Initiative for Asthma (GINA) Steps 2, 3 or 4.

Methods

This is a post hoc analysis of the results of five large clinical trials (>12000 patients) comparing BUD/FORM maintenance and reliever therapy with other treatments categorised by treatment step at study entry. Both current clinical asthma control during the last week of treatment and exacerbations during the study were examined.

Results

At each GINA treatment step, the proportion of patients achieving target levels of current clinical control were similar or higher with BUD/FORM maintenance and reliever therapy compared with the same or a higher fixed maintenance dose of inhaled corticosteroid/long-acting β₂-agonist (ICS/LABA) (plus short-acting β₂-agonist [SABA] as reliever), and rates of exacerbations were lower at all treatment steps in BUD/FORM maintenance and reliever therapy versus same maintenance dose ICS/LABA (P < 0.01) and at treatment Step 4 versus higher maintenance dose ICS/LABA (P < 0.001). BUD/FORM maintenance and reliever therapy also achieved significantly higher rates of current clinical control and significantly lower exacerbation rates at most treatment steps compared with a higher maintenance dose ICS + SABA (Steps 2-4 for control and Steps 3 and 4 for exacerbations). With all treatments, the proportion of patients achieving current clinical control was lower with increasing treatment steps.

Conclusions

BUD/FORM maintenance and reliever therapy may be a preferable option for patients on Steps 2 to 4 of asthma guidelines requiring a more effective treatment and, compared with other fixed dose alternatives, is most effective in the higher treatment steps.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3082240

DOI: 10.1186/1465-9921-12-38
PubMed: 21463522
PubMed Central: 3082240

Affiliations:

Le document en format XML

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<author><name sortKey="Bateman, Eric D" sort="Bateman, Eric D" uniqKey="Bateman E" first="Eric D" last="Bateman">Eric D. Bateman</name>
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<country xml:lang="fr">France</country>
<wicri:regionArea>Université Paris-Sud 11, Centre National de Référence de L'Hypertension Artérielle Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital Antoine-Béclère, Clamar Cedex</wicri:regionArea>
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<author><name sortKey="Jenkins, Christine R" sort="Jenkins, Christine R" uniqKey="Jenkins C" first="Christine R" last="Jenkins">Christine R. Jenkins</name>
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<placeName><settlement type="city">Sydney</settlement>
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<author><name sortKey="Peterson, Stefan" sort="Peterson, Stefan" uniqKey="Peterson S" first="Stefan" last="Peterson">Stefan Peterson</name>
<affiliation wicri:level="1"><nlm:aff id="I7">AstraZeneca Research and Development, Lund, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>AstraZeneca Research and Development, Lund</wicri:regionArea>
<wicri:noRegion>Lund</wicri:noRegion>
</affiliation>
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<author><name sortKey="Ostlund, Ollie" sort="Ostlund, Ollie" uniqKey="Ostlund O" first="Ollie" last="Östlund">Ollie Östlund</name>
<affiliation wicri:level="1"><nlm:aff id="I7">AstraZeneca Research and Development, Lund, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>AstraZeneca Research and Development, Lund</wicri:regionArea>
<wicri:noRegion>Lund</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="O Byrne, Paul M" sort="O Byrne, Paul M" uniqKey="O Byrne P" first="Paul M" last="O'Byrne">Paul M. O'Byrne</name>
<affiliation wicri:level="4"><nlm:aff id="I8">Michael G DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Michael G DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario</wicri:regionArea>
<orgName type="university">Université McMaster</orgName>
<placeName><settlement type="city">Hamilton (Ontario)</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sears, Malcolm R" sort="Sears, Malcolm R" uniqKey="Sears M" first="Malcolm R" last="Sears">Malcolm R. Sears</name>
<affiliation wicri:level="4"><nlm:aff id="I8">Michael G DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Michael G DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario</wicri:regionArea>
<orgName type="university">Université McMaster</orgName>
<placeName><settlement type="city">Hamilton (Ontario)</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Eriksson, Goran S" sort="Eriksson, Goran S" uniqKey="Eriksson G" first="Göran S" last="Eriksson">Göran S. Eriksson</name>
<affiliation wicri:level="1"><nlm:aff id="I7">AstraZeneca Research and Development, Lund, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>AstraZeneca Research and Development, Lund</wicri:regionArea>
<wicri:noRegion>Lund</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="I9">Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>Department of Respiratory Medicine and Allergology, University Hospital, Lund</wicri:regionArea>
<wicri:noRegion>Lund</wicri:noRegion>
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<idno type="ISSN">1465-9921</idno>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Adjusting medication for uncontrolled asthma involves selecting one of several options from the same or a higher treatment step outlined in asthma guidelines. We examined the relative benefit of introducing budesonide/formoterol (BUD/FORM) maintenance and reliever therapy (Symbicort SMART<sup>® </sup>
Turbuhaler<sup>®</sup>
) in patients previously prescribed treatments from Global Initiative for Asthma (GINA) Steps 2, 3 or 4.</p>
</sec>
<sec><title>Methods</title>
<p>This is a <italic>post hoc </italic>
analysis of the results of five large clinical trials (>12000 patients) comparing BUD/FORM maintenance and reliever therapy with other treatments categorised by treatment step at study entry. Both current clinical asthma control during the last week of treatment and exacerbations during the study were examined.</p>
</sec>
<sec><title>Results</title>
<p>At each GINA treatment step, the proportion of patients achieving target levels of current clinical control were similar or higher with BUD/FORM maintenance and reliever therapy compared with the same or a higher fixed maintenance dose of inhaled corticosteroid/long-acting β<sub>2</sub>
-agonist (ICS/LABA) (plus short-acting β<sub>2</sub>
-agonist [SABA] as reliever), and rates of exacerbations were lower at all treatment steps in BUD/FORM maintenance and reliever therapy versus same maintenance dose ICS/LABA (P < 0.01) and at treatment Step 4 versus higher maintenance dose ICS/LABA (P < 0.001). BUD/FORM maintenance and reliever therapy also achieved significantly higher rates of current clinical control and significantly lower exacerbation rates at most treatment steps compared with a higher maintenance dose ICS + SABA (Steps 2-4 for control and Steps 3 and 4 for exacerbations). With all treatments, the proportion of patients achieving current clinical control was lower with increasing treatment steps.</p>
</sec>
<sec><title>Conclusions</title>
<p>BUD/FORM maintenance and reliever therapy may be a preferable option for patients on Steps 2 to 4 of asthma guidelines requiring a more effective treatment and, compared with other fixed dose alternatives, is most effective in the higher treatment steps.</p>
</sec>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="O Byrne, Pm" uniqKey="O Byrne P">PM O'Byrne</name>
</author>
<author><name sortKey="Bisgaard, H" uniqKey="Bisgaard H">H Bisgaard</name>
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<biblStruct><analytic><author><name sortKey="Kuna, P" uniqKey="Kuna P">P Kuna</name>
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</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bousquet, J" uniqKey="Bousquet J">J Bousquet</name>
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<author><name sortKey="Magnussen, H" uniqKey="Magnussen H">H Magnussen</name>
</author>
<author><name sortKey="Quiralte, J" uniqKey="Quiralte J">J Quiralte</name>
</author>
<author><name sortKey="Martinez Aguilar, Ne" uniqKey="Martinez Aguilar N">NE Martinez-Aguilar</name>
</author>
<author><name sortKey="Carlsheimer, A" uniqKey="Carlsheimer A">A Carlsheimer</name>
</author>
</analytic>
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<author><name sortKey="Atienza, T" uniqKey="Atienza T">T Atienza</name>
</author>
<author><name sortKey="Magyar, P" uniqKey="Magyar P">P Magyar</name>
</author>
<author><name sortKey="Larsson, P" uniqKey="Larsson P">P Larsson</name>
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<author><name sortKey="Jorup, C" uniqKey="Jorup C">C Jorup</name>
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<author><name sortKey="Lalloo, Ug" uniqKey="Lalloo U">UG Lalloo</name>
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<author><name sortKey="Reddel, Hk" uniqKey="Reddel H">HK Reddel</name>
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<author><name sortKey="Eriksson, G" uniqKey="Eriksson G">G Eriksson</name>
</author>
<author><name sortKey="Peterson, S" uniqKey="Peterson S">S Peterson</name>
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<author><name sortKey="Ostlund, O" uniqKey="Ostlund O">O Ostlund</name>
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<author><name sortKey="O Byrne, Pm" uniqKey="O Byrne P">PM O'Byrne</name>
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</author>
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<author><name sortKey="Busse, Ww" uniqKey="Busse W">WW Busse</name>
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<author><name sortKey="Clark, Tj" uniqKey="Clark T">TJ Clark</name>
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<author><name sortKey="Gul, N" uniqKey="Gul N">N Gul</name>
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<author><name sortKey="Bateman, Ed" uniqKey="Bateman E">ED Bateman</name>
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<author><name sortKey="Busse, Ww" uniqKey="Busse W">WW Busse</name>
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<author><name sortKey="Casale, Tb" uniqKey="Casale T">TB Casale</name>
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<author><name sortKey="Chanez, P" uniqKey="Chanez P">P Chanez</name>
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<author><name sortKey="Enright, Pl" uniqKey="Enright P">PL Enright</name>
</author>
<author><name sortKey="Gibson, Pg" uniqKey="Gibson P">PG Gibson</name>
</author>
<author><name sortKey="De Jongste, Jc" uniqKey="De Jongste J">JC De Jongste</name>
</author>
<author><name sortKey="Kerstjens, Ha" uniqKey="Kerstjens H">HA Kerstjens</name>
</author>
<author><name sortKey="Lazarus, Sc" uniqKey="Lazarus S">SC Lazarus</name>
</author>
<author><name sortKey="Levy, Ml" uniqKey="Levy M">ML Levy</name>
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<author><name sortKey="O Byrne, Pm" uniqKey="O Byrne P">PM O'Byrne</name>
</author>
<author><name sortKey="Partridge, Mr" uniqKey="Partridge M">MR Partridge</name>
</author>
<author><name sortKey="Pavord, Id" uniqKey="Pavord I">ID Pavord</name>
</author>
<author><name sortKey="Sears, Mr" uniqKey="Sears M">MR Sears</name>
</author>
<author><name sortKey="Sterk, Pj" uniqKey="Sterk P">PJ Sterk</name>
</author>
<author><name sortKey="Stoloff, Sw" uniqKey="Stoloff S">SW Stoloff</name>
</author>
<author><name sortKey="Sullivan, Sd" uniqKey="Sullivan S">SD Sullivan</name>
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<author><name sortKey="Szefler, Sj" uniqKey="Szefler S">SJ Szefler</name>
</author>
<author><name sortKey="Thomas, Md" uniqKey="Thomas M">MD Thomas</name>
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<author><name sortKey="Wenzel, Se" uniqKey="Wenzel S">SE Wenzel</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bateman, Ed" uniqKey="Bateman E">ED Bateman</name>
</author>
<author><name sortKey="Boushey, Ha" uniqKey="Boushey H">HA Boushey</name>
</author>
<author><name sortKey="Bousquet, J" uniqKey="Bousquet J">J Bousquet</name>
</author>
<author><name sortKey="Busse, Ww" uniqKey="Busse W">WW Busse</name>
</author>
<author><name sortKey="Clark, Tj" uniqKey="Clark T">TJ Clark</name>
</author>
<author><name sortKey="Pauwels, Ra" uniqKey="Pauwels R">RA Pauwels</name>
</author>
<author><name sortKey="Pedersen, Se" uniqKey="Pedersen S">SE Pedersen</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Sears, Mr" uniqKey="Sears M">MR Sears</name>
</author>
<author><name sortKey="Radner, F" uniqKey="Radner F">F Radner</name>
</author>
</analytic>
</biblStruct>
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</div1>
</back>
</TEI>
<affiliations><list><country><li>Afrique du Sud</li>
<li>Allemagne</li>
<li>Australie</li>
<li>Canada</li>
<li>Espagne</li>
<li>France</li>
<li>Royaume-Uni</li>
<li>Suède</li>
</country>
<region><li>Communauté de Madrid</li>
<li>Nouvelle-Galles du Sud</li>
<li>Ontario</li>
<li>Rhénanie-Palatinat</li>
</region>
<settlement><li>Hamilton (Ontario)</li>
<li>Madrid</li>
<li>Mayence</li>
<li>Sydney</li>
</settlement>
<orgName><li>Université McMaster</li>
<li>Université autonome de Madrid</li>
</orgName>
</list>
<tree><country name="Afrique du Sud"><noRegion><name sortKey="Bateman, Eric D" sort="Bateman, Eric D" uniqKey="Bateman E" first="Eric D" last="Bateman">Eric D. Bateman</name>
</noRegion>
</country>
<country name="Royaume-Uni"><noRegion><name sortKey="Harrison, Tim W" sort="Harrison, Tim W" uniqKey="Harrison T" first="Tim W" last="Harrison">Tim W. Harrison</name>
</noRegion>
</country>
<country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Quirce, Santiago" sort="Quirce, Santiago" uniqKey="Quirce S" first="Santiago" last="Quirce">Santiago Quirce</name>
</region>
</country>
<country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Reddel, Helen K" sort="Reddel, Helen K" uniqKey="Reddel H" first="Helen K" last="Reddel">Helen K. Reddel</name>
</region>
<name sortKey="Jenkins, Christine R" sort="Jenkins, Christine R" uniqKey="Jenkins C" first="Christine R" last="Jenkins">Christine R. Jenkins</name>
</country>
<country name="Allemagne"><region name="Rhénanie-Palatinat"><name sortKey="Buhl, Roland" sort="Buhl, Roland" uniqKey="Buhl R" first="Roland" last="Buhl">Roland Buhl</name>
</region>
</country>
<country name="France"><noRegion><name sortKey="Humbert, Marc" sort="Humbert, Marc" uniqKey="Humbert M" first="Marc" last="Humbert">Marc Humbert</name>
</noRegion>
</country>
<country name="Suède"><noRegion><name sortKey="Peterson, Stefan" sort="Peterson, Stefan" uniqKey="Peterson S" first="Stefan" last="Peterson">Stefan Peterson</name>
</noRegion>
<name sortKey="Eriksson, Goran S" sort="Eriksson, Goran S" uniqKey="Eriksson G" first="Göran S" last="Eriksson">Göran S. Eriksson</name>
<name sortKey="Eriksson, Goran S" sort="Eriksson, Goran S" uniqKey="Eriksson G" first="Göran S" last="Eriksson">Göran S. Eriksson</name>
<name sortKey="Ostlund, Ollie" sort="Ostlund, Ollie" uniqKey="Ostlund O" first="Ollie" last="Östlund">Ollie Östlund</name>
</country>
<country name="Canada"><region name="Ontario"><name sortKey="O Byrne, Paul M" sort="O Byrne, Paul M" uniqKey="O Byrne P" first="Paul M" last="O'Byrne">Paul M. O'Byrne</name>
</region>
<name sortKey="Sears, Malcolm R" sort="Sears, Malcolm R" uniqKey="Sears M" first="Malcolm R" last="Sears">Malcolm R. Sears</name>
</country>
</tree>
</affiliations>
</record>

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   |texte=   Overall asthma control achieved with budesonide/formoterol maintenance and reliever therapy for patients on different treatment steps
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Serveur d'exploration sur les relations entre la France et l'Australie

Overall asthma control achieved with budesonide/formoterol maintenance and reliever therapy for patients on different treatment steps

Overall asthma control achieved with budesonide/formoterol maintenance and reliever therapy for patients on different treatment steps

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Abstract

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	Serveur d'exploration sur les relations entre la France et l'Australie
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