title: Effect of switching from salmeterol/fluticasone to formoterol/ budesonide combinations in patients with uncontrolled asthma.
abstract: BACKGROUND
  Combination therapy with an inhaled corticosteroid (ICS) and a long-acting β(2)-agonist (LABA) in a single inhaler is the mainstay of asthma management and salmeterol/fluticasone combination (SFC) and fixed-dose formoterol/budesonide combination (FBC) are currently available in Japan; however, there is nothing to choose between the two. The purpose of this study was to clarify the effect of switching from SFC to FBC in patients with asthma not adequately controlled under the former treatment regimen.
  
  
  METHODS
  This was a prospective, multicenter, open-label, uncontrolled longitudinal study in 87 adult patients with an Asthma Control Questionnaire, 5-item version (ACQ5) score of greater than 0.75 under treatment with SFC 50/250μg one inhalation twice daily (bid). SFC was switched to FBC 4.5/160μg two inhalations bid. Study outcomes included ACQ5 score, peak expiratory flow (PEF), FEV(1), and fractional exhaled nitric oxide (FeNO) at the end of treatment period.
  
  
  RESULTS
  Eighty-three patients completed the study. ACQ5 scores improved and exceeded the clinically meaningful difference after 12 weeks of treatment and well-controlled asthma (ACQ5 score ≤0.75) was attained in 37 (44.6%) patients. Minimum and maximum PEF and FEV(1) values improved significantly, but not FeNO values, after switching from SFC to FBC.
  
  
  CONCLUSIONS
  Switching ICS/LABA combination therapy is a useful option in the management of asthma that is not optimally controlled.
authors.affiliation: Department of Respiratory Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Akamatsu
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Shirai
authors.forename: Masato
authors.initials: M
authors.lastname: Kato
authors.forename: Dai
authors.initials: D
authors.lastname: Hashimoto
authors.forename: Hideki
authors.initials: H
authors.lastname: Yasui
authors.forename: Naoki
authors.initials: N
authors.lastname: Inui
authors.forename: Takafumi
authors.initials: T
authors.lastname: Suda
authors.forename: Koshi
authors.initials: K
authors.lastname: Yokomura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hayakawa
authors.forename: Kyotaro
authors.initials: K
authors.lastname: Ide
authors.forename: Mikio
authors.initials: M
authors.lastname: Toyoshima
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kuroishi
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Yasuda
authors.forename: Hideki
authors.initials: H
authors.lastname: Suganuma
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamada
authors.forename: Masafumi
authors.initials: M
authors.lastname: Masuda
authors.forename: Kingo
authors.initials: K
authors.lastname: Chida
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000420:Albuterol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000730:Androstadienes / Q000008:administration & dosage* / Q000009:adverse effects; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D019819:Budesonide / Q000008:administration & dosage* / Q000009:adverse effects; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D004983:Ethanolamines / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D000068298:Fluticasone; D000068759:Formoterol Fumarate; D006801:Humans; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D000068299:Salmeterol Xinafoate; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D000730:Androstadienes; D004983:Ethanolamines; D019819:Budesonide; D000068299:Salmeterol Xinafoate; D000068298:Fluticasone; D000420:Albuterol; D000068759:Formoterol Fumarate