title: Real-world effects of two inhaled corticosteroid/long-acting β₂-agonist combinations in the treatment of asthma.
abstract: OBJECTIVE
  There are several inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combinations currently used to treat asthmatic patients, but the differences in the clinical effects of these ICS/LABAs are currently unknown. We herein evaluated the effects of two currently available ICS/LABA combinations in a real-world setting.
  
  
  METHODS
  A fluticasone propionate/salmeterol combined Discus inhaler (FP/SM; 250/50 μg bid) was switched to a budesonide/formoterol Turbuhaler inhaler (BUD/FM; 160/4.5 μg two inhalations bid) and FP/SM (500/50 μg bid) was also switched to BUD/FM (160/4.5 μg four inhalations bid) in symptomatic asthmatic patients treated with FP/SM over 20 years of age.
  
  
  RESULTS
  Sixty patients were enrolled in this study, and the scores of the asthma control test (ACT) and asthma control questionnaire-5 item version (ACQ5) were significantly improved 4 and 8 weeks after the switch to ICS/LABA treatments, and well-controlled asthma (ACQ5 score <0.75) and good control (ACT score >20) was achieved in 54 (90%) and 40 (66.7%) patients, respectively, at 8 weeks. The spirometric analysis revealed significant improvements of the values of the peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1) after switching from FP/SM to BUD/FM, and significantly improved small airway impairments ([Formula: see text]50 and [Formula: see text]25) were observed in patients treated with high-dose ICS/LABA. These subjective and objective improvements were also seen in patients aged over 65 years old.
  
  
  CONCLUSIONS
  These data demonstrated that changing the combined ICS/LABA inhaler from FP/SM to BUD/FM can lead to more effective management of symptomatic patients with asthma, especially in patients treated with high-dose ICS/LABA.
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan , Kitakyushu city, Fukuoka , Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yatera
authors.forename: Kei
authors.initials: K
authors.lastname: Yamasaki
authors.forename: Chinatsu
authors.initials: C
authors.lastname: Nishida
authors.forename: Shingo
authors.initials: S
authors.lastname: Noguchi
authors.forename: Keishi
authors.initials: K
authors.lastname: Oda
authors.forename: Kentarou
authors.initials: K
authors.lastname: Akata
authors.forename: Shuya
authors.initials: S
authors.lastname: Nagata
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kawanami
authors.forename: Toshinori
authors.initials: T
authors.lastname: Kawanami
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishimoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mukae
mesh_terms: D000280:Administration, Inhalation; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000730:Androstadienes / Q000008:administration & dosage*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D019819:Budesonide / Q000008:administration & dosage*; D004338:Drug Combinations; D004983:Ethanolamines / Q000008:administration & dosage*; D000068297:Fluticasone-Salmeterol Drug Combination; D005541:Forced Expiratory Volume; D000068759:Formoterol Fumarate; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010366:Peak Expiratory Flow Rate; D011795:Surveys and Questionnaires
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D004338:Drug Combinations; D004983:Ethanolamines; D000068297:Fluticasone-Salmeterol Drug Combination; D019819:Budesonide; D000420:Albuterol; D000068759:Formoterol Fumarate
keywords: Asthma; asthma control questionnaire; asthma control test; budesonide/formoterol; elderly patients; fluticasone propionate/salmeterol; inhaled corticosteroid; long-acting β2-agonist; spirometry