A randomized, comparative study of formoterol and terbutaline dry powder inhalers in the treatment of mild to moderate asthma exacerbations in the pediatric acute care setting.
BACKGROUND
Formoterol is a fast-acting, long-acting beta-agonist. Its on-demand use by outpatients has been beneficial in controlling asthma.


OBJECTIVE
To evaluate the efficacy of formoterol as rescue medication for pediatric asthma exacerbation.


METHODS
A randomized, double-blind study was conducted on parallel groups involving 79 pediatric patients (mean [SD] age, 9.92 [2.5] years) with mild to moderate asthma exacerbations. They were treated with up to 3 doses of formoterol aerolizer, 12 microg, or terbutaline Turbuhaler, 0.5 mg (dry powder inhalers). Respiratory rate, clinical score, pulse oximetry, and spirometry were analyzed at baseline and 15 minutes after administration of each bronchodilator dose. All the patients received oral prednisolone, 1 mg/kg, at study entry, followed by a single daily dose for 4 days. Forty-one patients were treated with formoterol and 38 with terbutaline. The groups were comparable in age and in severity of asthma exacerbation.


RESULTS
Both treatments resulted in similar clinical and functional improvement; 37 patients (47%) required 1 bronchodilator dose. Increases of 19.5% and 15.3% occurred in forced expiratory volume in 1 second in the formoterol and terbutaline groups, respectively. Therapeutic failures occurred in 2 patients. No adverse effects were observed. At 1-week follow-up, patients were stable, with pulmonary function close to normal.


CONCLUSIONS
Formoterol therapy was at least as effective as terbutaline therapy in children and adolescents with mild and moderate asthma exacerbations.
Pulmonology Unit, Child Institute (Instituto da Criança), University of São Paulo Medical School, São Paulo, Brazil.
Maria H
MH
Bussamra
Rafael
R
Stelmach
Joaquim C
JC
Rodrigues
Alberto
A
Cukier
D000280:Administration, Inhalation; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D018450:Disease Progression; D004632:Emergency Medical Services; D004983:Ethanolamines / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D000068759:Formoterol Fumarate; D006801:Humans; D008297:Male; D011208:Powders / Q000008:administration & dosage; D012129:Respiratory Function Tests; D013726:Terbutaline / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D004983:Ethanolamines; D011208:Powders; D013726:Terbutaline; D000068759:Formoterol Fumarate