title: ADRB2 polymorphisms and budesonide/formoterol responses in COPD.
abstract: BACKGROUND
  Effects of β(2)-adrenergic receptor gene (ADRB2) polymorphism on therapeutic responses to long-acting β(2)-adrenergic agonists have not been evaluated in long-term COPD trials. We aimed to investigate the effects of the ADRB2 Gly16Arg polymorphism on response to formoterol alone or in combination with the inhaled corticosteroid budesonide in patients with COPD.
  
  
  METHODS
  Patients ≥ 40 years of age with moderate to very severe COPD from the 12-month trial I (NCT00206167) or the 6-month trial II (NCT00206154) were randomly assigned to bid budesonide/formoterol pressurized metered-dose inhaler (pMDI) 320/9 μg or 160/9 μg, budesonide pMDI 320 μg + formoterol dry powder inhaler 9 μg (trial II), budesonide pMDI 320 μg (trial II), formoterol dry powder inhaler 9 μg, or placebo. The effect of Gly16Arg on predose FEV(1) and 1-h postdose FEV(1), exacerbations, diary variables, and adverse events were analyzed.
  
  
  RESULTS
  No significant interaction between genotype and treatment response was observed for predose (P ≥ .197) or postdose FEV(1) (P ≥ .125) in either pharmacogenetic study (n = 2,866). The number of COPD exacerbations per patient-treatment year was low and similar across genotypes for the active treatment groups (both studies). Percentages of patients with adverse events were similar across Gly16Arg genotype groups for each treatment.
  
  
  CONCLUSIONS
  Therapeutic response and tolerability to long-term treatment with formoterol alone or in combination with budesonide was not modified by ADRB2 Gly16Arg genotype in two large independent pharmacogenetic studies in patients with moderate to very severe COPD.
authors.affiliation: Center for Genomics and Personalized Medicine, Wake Forest School of Medicine, Winston-Salem, NC. Electronic address: ebleeck@wakehealth.edu.
authors.forename: Eugene R
authors.initials: ER
authors.lastname: Bleecker
authors.affiliation: Center for Genomics and Personalized Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Meyers
authors.affiliation: University of Alabama Lung Health Center, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: William C
authors.initials: WC
authors.lastname: Bailey
authors.affiliation: AstraZeneca, Alderley Park, England.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Sims
authors.affiliation: AstraZeneca, Alderley Park, England.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Bujac
authors.affiliation: AstraZeneca LP, Wilmington, DE.
authors.forename: Mitch
authors.initials: M
authors.lastname: Goldman
authors.affiliation: AstraZeneca LP, Wilmington, DE.
authors.forename: Ubaldo J
authors.initials: UJ
authors.lastname: Martin
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000368:Aged; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D019819:Budesonide / Q000627:therapeutic use*; D000069502:Budesonide, Formoterol Fumarate Drug Combination; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004338:Drug Combinations; D004361:Drug Tolerance / Q000235:genetics; D004983:Ethanolamines / Q000627:therapeutic use*; D005260:Female; D000068759:Formoterol Fumarate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic / Q000235:genetics; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000235:genetics* / Q000503:physiopathology; D018343:Receptors, Adrenergic, beta-2 / Q000235:genetics*; D016896:Treatment Outcome
chemical_list: C553443:ADRB2 protein, human; D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents; D000069502:Budesonide, Formoterol Fumarate Drug Combination; D004338:Drug Combinations; D004983:Ethanolamines; D018343:Receptors, Adrenergic, beta-2; D019819:Budesonide; D000068759:Formoterol Fumarate