Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease

• Published in: The European respiratory journal Vol. 21; no. 1; pp. 74 - 81
• Main Authors: Szafranski, W, Cukier, A, Ramirez, A, Menga, G, Sansores, R, Nahabedian, S, Peterson, S, Olsson, H
• Format: Journal Article
• Language: English
• Published: Leeds Eur Respiratory Soc 01.01.2003; Maney
• Subjects: Administration, Inhalation; Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - therapeutic use; Adrenergic beta-Agonists - administration & dosage; Adrenergic beta-Agonists - therapeutic use; Biological and medical sciences; Budesonide - administration & dosage; Budesonide - therapeutic use; Budesonide, Formoterol Fumarate Drug Combination; Double-Blind Method; Drug Combinations; Ethanolamines - administration & dosage; Ethanolamines - therapeutic use; Female; Forced Expiratory Volume; Formoterol Fumarate; Humans; Male; Medical sciences; Middle Aged; Peak Expiratory Flow Rate; Pharmacology. Drug treatments; Pulmonary Disease, Chronic Obstructive - drug therapy; Respiratory system; Time Factors; Human; Lung disease; Budesonide; Corticosteroid; Drug combination; Prognosis; Respiratory disease; Bronchodilator; β-Adrenergic receptor agonist; Inhalation; Chemotherapy; Chronic; Lung function; Treatment; Follow up study; Bronchus disease; Formoterol; Obstructive pulmonary disease
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/09031936.03.00031402

The efficacy and safety of budesonide/formoterol in a single inhaler compared with placebo, budesonide and formoterol were evaluated in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). In a 12-month, randomised, double-blind, placebo-controlled, parallel-group study in 812 adults (mean age 64 yrs, mean forced expiratory volume in one second (FEV1) 36% predicted normal), patients received two inhalations twice daily of either budesonide/formoterol (Symbicort) 160/4.5 microg (delivered dose), budesonide 200 microg (metered dose), formoterol 4.5 microg or placebo. Severe exacerbations and FEV1 (primary variables), peak expiratory flow (PEF), COPD symptoms, health-related quality of life (HRQL), mild exacerbations, use of reliever beta2-agonist and safety variables were recorded. Budesonide/formoterol reduced the mean number of severe exacerbations per patient per year by 24% versus placebo and 23% versus formoterol. FEV1 increased by 15% versus placebo and 9% versus budesonide. Morning PEF improved significantly on day 1 versus placebo and budesonide; after 1 week, morning PEF was improved versus placebo, budesonide and formoterol. Improvements in morning and evening PEF versus comparators were maintained over 12 months. Budesonide/formoterol decreased all symptom scores and use of reliever beta2-agonists significantly versus placebo and budesonide, and improved HRQL versus placebo. All treatments were well tolerated. These results suggest a role for budesonide/formoterol in the long-term management of moderate-to-severe chronic obstructive pulmonary disease.