Combination formoterol and inhaled steroid vs. beta(2)-agonist as relief medication for chronic asthma

In moderate to severe asthma, combined budesonide/formoterol inhaler for relief of asthma symptoms appears to reduce exacerbations but not hospital admissions compared with a beta2-agonist alone. In mild asthma, the combination may not provide any clinically important benefits compared with formoterol alone.

A Cochrane review included 3 studies with a total of 5 905 subjects (including 341 children aged 4 to 11). In patients with mild asthma who do not need maintenance treatment, no clinically important advantages of budesonide/formoterol as reliever were found in comparison to formoterol as reliever. In more severe asthma (not controlled on high doses of inhaled corticosteroids, at least one exacerbation in the previous year), one adult study found a reduction in exacerbations requiring oral corticosteroids compared to terbutaline (OR 0.56, 95% CI 0.42 to 0.74). Hospitalisations related to asthma were not statistically significantly reduced in the two studies comparing budesonide/formoterol for maintenance and relief with the same dose of budesonide/formoterol for maintenance with terbutaline for relief (OR 0.68, 95% CI 0.40 to 1.16).

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in patient populations, interventions and outcomes).

Ədəbiyyat

1. Cates CJ, Lasserson TJ. Combination formoterol and inhaled steroid versus beta(2)-agonist as relief medication for chronic asthma in adults and children. Cochrane Database Syst Rev 2009;(1):CD007085.