title: Do inhaled corticosteroid/long-acting beta2-agonist fixed combinations provide superior clinical benefits compared with separate inhalers? A literature reappraisal.
abstract: Current asthma management guidelines emphasize the importance of disease control. Although effective drug therapies are available, real-life data indicate that the general level of asthma control is still low. Fixed-dose combinations of inhaled corticosteroids/long-acting beta(2)-agonists (ICS/LABAs) are now increasingly used in the management of asthma. A number of studies have compared the clinical benefits of ICS/LABA fixed combinations with the monocomponents administered using two separate inhalers. We conducted a database search to identify all published studies that have assessed whether fixed-dose combinations achieve greater asthma control compared with administration by separate inhalers. Among fixed combinations, only extrafine beclomethasone/formoterol provided significantly greater asthma control compared with separate inhalers administered as larger aerosol particles. This greater effect may be explained by increased delivery to the small airways by the extrafine formulation.
authors.affiliation: National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Barnes
authors.forename: Gabriele
authors.initials: G
authors.lastname: Nicolini
authors.forename: Andrea
authors.initials: A
authors.lastname: Bizzi
authors.forename: Monica
authors.initials: M
authors.lastname: Spinola
authors.forename: Dave
authors.initials: D
authors.lastname: Singh
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy*; D001507:Beclomethasone / Q000008:administration & dosage; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D004983:Ethanolamines / Q000008:administration & dosage; D000068759:Formoterol Fumarate; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D009330:Nebulizers and Vaporizers; D010316:Particle Size; D016032:Randomized Controlled Trials as Topic
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D004338:Drug Combinations; D004983:Ethanolamines; D007166:Immunosuppressive Agents; D001507:Beclomethasone; D000068759:Formoterol Fumarate