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Albuterol, Budesonide/ Formoterol Inhalers Appear to Work Faster Than Fluticasone/ Salmeterol in Adults With Asthma: Presented at AAAAI

By Ed Susman

PHILADELPHIA -- March 19, 2008 -- Adults with mild-to-moderate asthma appeared to achieve faster bronchodilatory effects when they use pressure-metered dose inhalers containing albuterol or budesonide/ formoterol than with fluticasone/ salmeterol dry-powder inhaler or placebo.

"The percentage of patients who achieved a 15% improvement in FEV₁ [forced expiratory volume in 1 second] within 15 minutes of dosing were significantly higher [P < .05] for all treatment groups compared with placebo," said Frank C. Hampel Jr., MD, Head, Central Texas Health Research, New Braunfels, Texas.

Dr. Hampel and colleagues performed two studies and pooled the data for analysis. They determined that a greater percentage of patients receiving albuterol and budesonide/ formoterol achieved a 15% improvement in FEV₁ within 15 minutes of treatment administration than did those receiving fluticasone/ salmeterol (P < .05).

The same pattern was shown for 12% improvement in FEV₁, with all the active agents performing faster than placebo, and with albuterol and budesonide/ formoterol performing faster than fluticasone/ salmeterol.

The two identically designed single-dose, randomised, 4-period crossover, active-controlled, and placebo-controlled studies enrolled 54 patients and 55 patients, respectively. The total patient population of 109 individuals was used to compute the combined results.

Dr. Hampel reported in his poster presentation on March 17 at the Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) that 15% improvement in FEV₁ was seen within 15 minutes in about 50% of patients taking albuterol, 40% of patients taking budesonide/ formoterol, 20% of patients taking fluticasone/ salmeterol, and 1% of patients taking placebo.

"These studies did not use a double-dummy study design," Dr. Hampel explained. "Therefore, although patients were not told what active ingredients they would receive during each period, they may have been able to identify the treatments."

No serious adverse events occurred in study 1. One placebo patient developed endometriosis, and a budesonide/formoterol patient was diagnosed with sinusitis in study 2. Neither adverse event was considered by the researchers to be related to a study drug.

Funding for the studies and pooled analysis was provided by AstraZeneca.

[Presentation title: Early Bronchodilatory Effects of Budesonide/ Formoterol Pressurized Metered-Dose Inhaler Compared With Fluticasone Propionate/ Salmeterol Dry Powder Inhaler and Albuterol Pressure Metered-Dose Inhaler in Adults With Asthma. Abstract 849]

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