Epidemiological and clinical characteristics, spirometric parameters and response to budesonide/formoterol in patients attending an asthma clinic: an experience in a developing country.
BACKGROUND
This study aims at describing the epidemiological and clinical characteristics, severity, reversibility testing and response to treatment using simple spirometry in asthmatic patients attending a model specialized Asthma Care Center.


METHODS
Eligible subjects must have a suggestive clinical picture and confirmed by spirometry to have a 12% plus 200ml absolute increase in FEV1 either by reversibility testing or after a therapeutic trial with inhaled and/or oral steroid therapy. Budesonide-Formoterol Turbohaler was used for reversibility testing and for maintenance therapy with or without the addition of oral prednisolone.


RESULTS
One hundred and nineteen patients were eligible for the study. Age ranged between 10 -70 years. One hundred and thirteen patients (95.0%) had an FEV1 less than 80% of predicted. One hundred and five patients (88.2%) had reversibility testing of whom 72 (68.6%) had a significant reversibility. Sixty two patients (52.1%) were prescribed Budesonide-Formoterol Turbohaler only whilst 57 were prescribed both Budesonide-Formoterol Turbohaler and oral prednisolone. Patients were reviewed after a mean of 14.9 days (range 6.0-28.0). Seventy two patients (60.5%) had increased their FEV1 to more than 80% of their predicted value. By logistic regression analysis, predicted FEV1 at baseline was a significant negative predictor of a complete response.


CONCLUSIONS
Most patients had abnormal spirometry with more than half having an FEV1 that is 60% or less of their predicted normal reading. Reversibility testing using Budesonide-Formoterol Turbohaler confirmed the fast onset of action of its Formoterol component and helped in cutting the cost of this test. The majority improved with treatment with 60% normalizing their spirometry highlighting the feasibility and applicability of specialized asthma care centers in resource-poor countries.
Saud bin Abdulaziz University for Health Sciences, Department of Medicine 1443, King Abdulaziz Medical City, King Fahad National Guard Hospital, PO Box 22490, Riyadh 11426, Kingdom of Saudi Arabia.
Hassan
H
Imad
Medical Officer, Department of Medicine, National Ribat University Hospital, Khartoum, Sudan.
Ged
G
Yasir
D000280:Administration, Inhalation; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D000069502:Budesonide, Formoterol Fumarate Drug Combination / Q000008:administration & dosage* / Q000627:therapeutic use; D002648:Child; D003906:Developing Countries; D005260:Female; D005541:Forced Expiratory Volume; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies; D013147:Spirometry; D016896:Treatment Outcome; D055815:Young Adult
D018927:Anti-Asthmatic Agents; D000069502:Budesonide, Formoterol Fumarate Drug Combination; D005938:Glucocorticoids; D011239:Prednisolone
Asthma; budesonide/formoterol; developing country; spirometry; therapy