ORIGINAL ARTICLE

Early asthma control and maintenance with eformoterol following reduction of inhaled corticosteroid dose

D Price¹, D Dutchman², A Mawson³, B Bodalia⁴, S Duggan⁵, P Todd⁵ on behalf of the FLOW (Eformoterol in the management of mild asthma—eformoterol Turbohaler with budesonide Turbohaler) Research Group

¹ Department of General Practice and Primary Care, University of Aberdeen, Aberdeen AB25 2AY, UK
² Roebuck House, High Street, Hastings, East Sussex TN34 3EY, UK
³ Church View Surgery, School Lane, Collingham, West Yorkshire LS22 5BQ, UK
⁴ The Gables Medicentre, 268 Holbrook Lane, Coventry CV6 4DD, UK
⁵ Clinical Research Group, AstraZeneca UK Ltd, Kings Langley, Herts WD4 8DH, UK

Correspondence to:
Correspondence to:
Professor D Price, General Practice Airways Group, Professor of Primary Care Respiratory Medicine, Department of General Practice and Primary Care, University of Aberdeen, Fosterhill Health Centre, Westburn Road, Aberdeen AB25 2AY, UK;
d.price{at}abdn.ac.uk

Background: Previous studies have indicated the benefits of adding long acting ß₂ agonists to inhaled corticosteroids in the maintenance treatment of moderate to severe asthma. The effects of adding eformoterol to corticosteroids on asthma control and exacerbations in patients with mild to moderate asthma were studied.

Methods: After a run in period of 7–14 days on existing medication, 663 symptomatic patients were randomised to receive budesonide Turbohaler 400 µg twice daily together with either eformoterol Turbohaler 9 µg (delivered dose) or placebo twice daily. After 4 weeks patients whose asthma was well controlled (n=505) were re-randomised to receive budesonide 400 µg daily and either eformoterol 9 µg or placebo twice daily for a further 6 months.

Results: Patients receiving eformoterol achieved asthma control 10 days sooner than those receiving budesonide alone, and improvements in lung function, symptoms, quality of life, and relief ß₂ agonist use were significantly greater with eformoterol. During the 6 month follow up the frequency of mild exacerbations was significantly lower in the eformoterol group than in those receiving budesonide alone (7.2 versus 10.5 per patient, 95% confidence interval for ratio 0.49 to 0.96, p=0.03). The time to first day of poorly controlled asthma was 97 days in the eformoterol group compared with 42 days in the placebo group (p=0.003).

Conclusions: Adding eformoterol to a low or moderate dose of budesonide in mild asthma resulted in faster and more effective control than treatment with budesonide alone. Eformoterol allowed the corticosteroid dose to be reduced while also decreasing the rate of mild exacerbations compared with budesonide alone. These data suggest a therapeutic advantage of adding eformoterol to inhaled corticosteroids in patients with mild to moderate asthma.

Keywords: asthma; eformoterol; budesonide; dose reduction

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Marginal benefits of adding formoterol

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