title: Difference in time-course of improvement in asthma control measures between budesonide and budesonide/formoterol.
abstract: Combinations of inhaled corticosteroids (ICS) and inhaled long-acting beta(2)-agonists (LABA) have become widely used for the initiation of maintenance treatment for asthma. However, it has not been fully elucidated whether ICS/LABA alters the time-course of different control outcome measures in steroid-naive patients with asthma compared to the treatment with ICS alone. We compared the time-response in Asthma Control Questionnaire (ACQ), forced expiratory volume in 1 s (FEV1), exhaled nitric oxide fraction (FE(NO)), and airway responsiveness to methacholine (PD(200)) between budesonide (BUD) and budesonide/formoterol (BUD/FM). BUD/FM therapy significantly improved the ACQ score at week 2 and week 4 (p < 0.01 and p < 0.05), and increased FEV1 and the methacholine threshold at week 8 and week 24 (all p < 0.05) compared to BUD alone. A logistic function model showed that the BUD/FM combination significantly improved ACQ, FEV1, FE(NO) and PD(200) at a faster rate than BUD over 24 weeks (p < 0.001 for ACQ, FEV1, PD(200), and p < 0.05 for FE(NO), z-test). A significant variance in the time-response was also found in the outcomes of the two treatment groups (FE(NO) and ACQ > FEV1 and PD(200), p < 0.001, z-test). The present study provides evidence that ICS/LABA combination therapy results in a more rapid improvement in asthma symptoms, lung function, and airway inflammation compared to ICS monotherapy in steroid-naive patients with asthma.
authors.affiliation: Third Department of Internal Medicine, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama 641-8509, Japan. kazmatsu@wakayama-med.ac.jp
authors.forename: Kazuto
authors.initials: K
authors.lastname: Matsunaga
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kawabata
authors.forename: Tsunahiko
authors.initials: T
authors.lastname: Hirano
authors.forename: Hisatoshi
authors.initials: H
authors.lastname: Sugiura
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Minakata
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ichinose
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage; D000328:Adult; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001944:Breath Tests; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D019819:Budesonide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004983:Ethanolamines / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D000068759:Formoterol Fumarate; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000032:analysis; D011446:Prospective Studies
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D001993:Bronchodilator Agents; D004983:Ethanolamines; D009569:Nitric Oxide; D019819:Budesonide; D000068759:Formoterol Fumarate