Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease

Lung function in chronic obstructive pulmonary disease (COPD) can be improved acutely by oral corticosteroids and bronchodilators. Whether clinical improvement can be maintained by subsequent inhaled therapy is unknown. COPD patients (n=1,022, mean prebronchodilator forced expiratory volume in one s...

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Veröffentlicht in:The European respiratory journal 2003-12, Vol.22 (6), p.912-919
Hauptverfasser: CALVERLEY, P. M, BOONSAWAT, W, CSEKE, Z, ZHONG, N, PETERSON, S, OLSSON, H
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container_end_page 919
container_issue 6
container_start_page 912
container_title The European respiratory journal
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creator CALVERLEY, P. M
BOONSAWAT, W
CSEKE, Z
ZHONG, N
PETERSON, S
OLSSON, H
description Lung function in chronic obstructive pulmonary disease (COPD) can be improved acutely by oral corticosteroids and bronchodilators. Whether clinical improvement can be maintained by subsequent inhaled therapy is unknown. COPD patients (n=1,022, mean prebronchodilator forced expiratory volume in one second (FEV1) 36% predicted) initially received formoterol (9 microg b.i.d.) and oral prednisolone (30 mg o.d.) for 2 weeks. After this time, patients were randomised to b.i.d. inhaled budesonide/formoterol 320/9 microg, budesonide 400 microg, formoterol 9 microg or placebo for 12 months. Postmedication FEV1 improved by 0.21 L and health-related quality of life using the St George's Respiratory Questionnaire (SGRQ) by 4.5 units after run-in. Fewer patients receiving budesonide/formoterol withdrew from the study than those receiving budesonide, formoterol or placebo. Budesonide/formoterol patients had a prolonged time to first exacerbation (254 versus 96 days) and maintained higher FEV1 (99% versus 87% of baseline), both primary variables versus placebo. They had fewer exacerbations (1.38 versus 1.80 exacerbations per patient per year), had higher prebronchodilator peak expiratory flow, and showed clinically relevant improvements in SGRQ versus placebo (-7.5 units). Budesonide/formoterol was more effective than either monocomponent in both primary variables. Budesonide/formoterol in a single inhaler (Symbicort) maintains the benefit of treatment optimisation, stabilising lung function and delaying exacerbations more effectively than either component drug alone or placebo.
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source MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
subjects Administration, Inhalation
Adrenergic beta-Agonists - administration & dosage
Adult
Aged
Aged, 80 and over
Anti-Inflammatory Agents - administration & dosage
Biological and medical sciences
Budesonide - administration & dosage
Double-Blind Method
Drug Combinations
Ethanolamines - administration & dosage
Female
Formoterol Fumarate
Humans
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Powders - administration & dosage
Pulmonary Disease, Chronic Obstructive - drug therapy
Respiratory system
Treatment Outcome
title Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease
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