Budesonide/Formoterol turbuhaler®: a review of its use in chronic obstructive pulmonary disease.
Summary of "Budesonide/Formoterol turbuhaler®: a review of its use in chronic obstructive pulmonary disease."
Chronic obstructive pulmonary disease (COPD) is a highly heterogeneous, progressive inflammatory disease that imposes considerable economic and healthcare burdens on society, with the disease predicted to remain a leading cause of morbidity and mortality worldwide in the future. Current pharmacological treatment can improve symptoms of the disease, but not progression. Global Initiative for Chronic Obstructive Lung Disease guidelines recommend that patients with moderate COPD should use one or more long-acting bronchodilators (e.g. a long-acting β(2)-agonist) as required and, for those with severe and very severe disease who are experiencing repeated COPD exacerbations, an inhaled corticosteroid should be added as required. Budesonide/formoterol Turbuhaler® (Symbicort® Turbuhaler®) is a dry powder inhaler (DPI) that combines these two classes of drugs in a single inhaler, thereby making administration easier and more convenient. Budesonide/formoterol Turbuhaler® (delivered dose 320 μg/9 μg) is recommended for the symptomatic treatment of adult patients with severe COPD (forced expiratory volume in 1 second <50% of predicted value) and a history of repeated exacerbations, who have significant symptoms despite regular therapy with long-acting bronchodilators. This article reviews the pharmacological properties and clinical use of budesonide/formoterol Turbuhaler® in adult patients with moderate to severe COPD. Budesonide/formoterol Turbuhaler® (320 μg/9 μg twice daily) was effective and well tolerated in adult patients with moderate to severe COPD participating in large, multicentre trials of up to 12 months' duration. Budesonide/formoterol Turbuhaler® improved lung function, exacerbation rates, COPD symptom scores and health status from baseline to a significantly greater extent than placebo and, in general, than the individual monotherapies in these trials. Moreover, as reflected in the faster onset of action of formoterol than salmeterol, budesonide/formoterol Turbuhaler® was more effective than salmeterol/fluticasone propionate DPI at improving the patient's ability to perform morning activities in a short-term study. In the 12-week CLIMB trial, adding budesonide/formoterol Turbuhaler® to inhaled tiotropium bromide therapy was significantly more effective than adding placebo to tiotropium bromide therapy. Thus, inhaled budesonide/formoterol, either alone or as add-on therapy to other medications, continues to be a useful option for the management of COPD.
Adis, Auckland, New Zealand.
This article was published in the following journal.
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22316354
- DOI: http://dx.doi.org/10.2165/11208460-000000000-00000
Medical and Biotech [MESH] Definitions
Pulmonary Disease, Chronic Obstructive
A disease of chronic diffuse irreversible airflow obstruction. Subcategories of COPD include CHRONIC BRONCHITIS and PULMONARY EMPHYSEMA.
Pulmonary Heart Disease
Hypertrophy and dilation of the RIGHT VENTRICLE of the heart that is caused by PULMONARY HYPERTENSION. This condition is often associated with pulmonary parenchymal or vascular diseases, such as CHRONIC OBSTRUCTIVE PULMONARY DISEASE and PULMONARY EMBOLISM.
A subcategory of CHRONIC OBSTRUCTIVE PULMONARY DISEASE. The disease is characterized by hypersecretion of mucus accompanied by a chronic (more than 3 months in 2 consecutive years) productive cough. Infectious agents are a major cause of chronic bronchitis.
Sleep Apnea, Central
A condition associated with multiple episodes of sleep apnea which are distinguished from obstructive sleep apnea (SLEEP APNEA, OBSTRUCTIVE) by the complete cessation of efforts to breathe. This disorder is associated with dysfunction of central nervous system centers that regulate respiration. This condition may be idiopathic (primary) or associated with lower brain stem lesions; chronic obstructive pulmonary disease (LUNG DISEASES, OBSTRUCTIVE); HEART FAILURE, CONGESTIVE; medication effect; and other conditions. Sleep maintenance is impaired, resulting in daytime hypersomnolence. Primary central sleep apnea is frequently associated with obstructive sleep apnea. When both forms are present the condition is referred to as mixed sleep apnea (see SLEEP APNEA SYNDROMES). (Adams et al., Principles of Neurology, 6th ed, p395; Neurol Clin 1996;14(3):611-28)
Plethysmography, Whole Body
Measurement of the volume of gas in the lungs, including that which is trapped in poorly communicating air spaces. It is of particular use in chronic obstructive pulmonary disease and emphysema. (Segen, Dictionary of Modern Medicine, 1992)
Objective: To assess efficacy/tolerability of once-daily budesonide/formoterol pressurized metered-dose inhaler (pMDI) versus budesonide pMDI (primary) and twice-daily budesonide/formoterol (secondary...
BACKGROUND: Breathlessness and exercise intolerance frequently impact the daily life of patients with COPD. METHODS: This double-blind, multicentre, three-period crossover study randomised 111 patient...
Aim:To evaluate the effect of inhaled formoterol-budesonide on airway remodeling in adult patients with moderate asthma.Methods:Thirty asthmatic patients and thirty control subjects were enrolled. Ast...
ABSTRACT: BACKGROUND: There are no published studies that have compared bronchodilatory effect of inhaled budesonide/formoterol combination with budesonide/salbutamol delivered by metered dose inhaler...
BACKGROUND: The management of asthma has changed since the introduction of budesonide/formoterol (Symbicort®) as both maintenance and reliever therapy (SMART). SMART and its effects on bronchial hyp...
A Comparison of Symbicort® pMDI 2 x 160/4.5 μg Bid and Symbicort® pMDI 2 x 80/4.5 μg Bid With Formoterol Turbuhaler®, Budesonide pMDI, the Combination of Formoterol Turbuhaler® and Budesonide pMDI, and Placebo in COPD Patients
The purpose of this study is to compare a combination asthma drug (Symbicort) with its two components, budesonide and formoterol, taken individually or in combination, and with placebo in...
The purpose of this study is to investigate the effect on exercise tolerance, lung function and symptoms after treatment with Symbicort, Oxis or placebo in patients with severe chronic obs...
The purpose of this study is to compare Symbicort in a pressurized metered-dose inhaler (pMDI) with formoterol and placebo in the long-term maintenance treatment of patients with chronic o...
This non-interventional study is to analyse the therapeutic effectiveness in patients with severe COPD following a generally accepted 12-week treatment period with Symbicort Turbuhaler, wh...
The purpose of this study is to determine if SYMBICORT® delivered via a pressurized metered-dose inhaler, referred to as a pMDI, is effective in preventing COPD exacerbations.