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Fast onset of effect of budesonide/formoterol versus salmeterol/fluticasone and salbutamol in patients with chronic obstructive pulmonary disease and reversible airway obstruction.
Respirology. 2007 Sep; 12(5):732-9.R

Abstract

BACKGROUND AND OBJECTIVES

Data on the onset of action of COPD medications are lacking. This study compared the onset of bronchodilation following different inhaled therapies in patients with moderate-to-severe COPD and reversible airway obstruction.

METHODS

In this double-blind, double-dummy, crossover study, 90 patients (aged >or=40 years; FEV(1) 30-70% predicted) were randomized to a single dose (two inhalations) of budesonide/formoterol 160/4.5 microg, salmeterol/fluticasone 25/250 microg, salbutamol 100 microg or placebo (via pressurized metered-dose inhalers) on four visits. The primary end-point was change in FEV(1) 5 min after drug inhalation; secondary end-points included inspiratory capacity (IC) and perception of onset of effect.

RESULTS

Budesonide/formoterol significantly improved FEV(1) at 5 min compared with placebo (P < 0.0001) and salmeterol/fluticasone (P = 0.0001). Significant differences were first observed at 3 min. Onset of effect was similar with budesonide/formoterol and salbutamol. Improvements in FEV(1) following active treatments were superior to placebo after 180 min (all P < 0.0001); both combinations were better than salbutamol at maintaining FEV(1) improvements (P <or= 0.0001) at 180 min. Active treatments improved IC at 15 and 185 min compared with placebo (P < 0.0001). Maximal IC was greater with budesonide/formoterol than salmeterol/fluticasone (P = 0.0184) at 65 min. Patients reported a positive response to the perceptions of the onset of effect question shortly after receiving active treatments (median time to onset 5 min for active treatments vs 20 min for placebo), with no significant difference between active treatments.

CONCLUSION

Budesonide/formoterol has an onset of bronchodilatory effect in patients with COPD and reversible airway obstruction that is faster than salmeterol/fluticasone and similar to salbutamol.

Authors+Show Affiliations

Department of Respiratory Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden. anne.lindberg@nll.seNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17875063

Citation

Lindberg, Anne, et al. "Fast Onset of Effect of Budesonide/formoterol Versus Salmeterol/fluticasone and Salbutamol in Patients With Chronic Obstructive Pulmonary Disease and Reversible Airway Obstruction." Respirology (Carlton, Vic.), vol. 12, no. 5, 2007, pp. 732-9.
Lindberg A, Szalai Z, Pullerits T, et al. Fast onset of effect of budesonide/formoterol versus salmeterol/fluticasone and salbutamol in patients with chronic obstructive pulmonary disease and reversible airway obstruction. Respirology. 2007;12(5):732-9.
Lindberg, A., Szalai, Z., Pullerits, T., & Radeczky, E. (2007). Fast onset of effect of budesonide/formoterol versus salmeterol/fluticasone and salbutamol in patients with chronic obstructive pulmonary disease and reversible airway obstruction. Respirology (Carlton, Vic.), 12(5), 732-9.
Lindberg A, et al. Fast Onset of Effect of Budesonide/formoterol Versus Salmeterol/fluticasone and Salbutamol in Patients With Chronic Obstructive Pulmonary Disease and Reversible Airway Obstruction. Respirology. 2007;12(5):732-9. PubMed PMID: 17875063.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fast onset of effect of budesonide/formoterol versus salmeterol/fluticasone and salbutamol in patients with chronic obstructive pulmonary disease and reversible airway obstruction. AU - Lindberg,Anne, AU - Szalai,Zsuzsanna, AU - Pullerits,Teet, AU - Radeczky,Eva, PY - 2007/9/19/pubmed PY - 2007/12/22/medline PY - 2007/9/19/entrez SP - 732 EP - 9 JF - Respirology (Carlton, Vic.) JO - Respirology VL - 12 IS - 5 N2 - BACKGROUND AND OBJECTIVES: Data on the onset of action of COPD medications are lacking. This study compared the onset of bronchodilation following different inhaled therapies in patients with moderate-to-severe COPD and reversible airway obstruction. METHODS: In this double-blind, double-dummy, crossover study, 90 patients (aged >or=40 years; FEV(1) 30-70% predicted) were randomized to a single dose (two inhalations) of budesonide/formoterol 160/4.5 microg, salmeterol/fluticasone 25/250 microg, salbutamol 100 microg or placebo (via pressurized metered-dose inhalers) on four visits. The primary end-point was change in FEV(1) 5 min after drug inhalation; secondary end-points included inspiratory capacity (IC) and perception of onset of effect. RESULTS: Budesonide/formoterol significantly improved FEV(1) at 5 min compared with placebo (P < 0.0001) and salmeterol/fluticasone (P = 0.0001). Significant differences were first observed at 3 min. Onset of effect was similar with budesonide/formoterol and salbutamol. Improvements in FEV(1) following active treatments were superior to placebo after 180 min (all P < 0.0001); both combinations were better than salbutamol at maintaining FEV(1) improvements (P <or= 0.0001) at 180 min. Active treatments improved IC at 15 and 185 min compared with placebo (P < 0.0001). Maximal IC was greater with budesonide/formoterol than salmeterol/fluticasone (P = 0.0184) at 65 min. Patients reported a positive response to the perceptions of the onset of effect question shortly after receiving active treatments (median time to onset 5 min for active treatments vs 20 min for placebo), with no significant difference between active treatments. CONCLUSION: Budesonide/formoterol has an onset of bronchodilatory effect in patients with COPD and reversible airway obstruction that is faster than salmeterol/fluticasone and similar to salbutamol. SN - 1323-7799 UR - https://www.unboundmedicine.com/medline/citation/17875063/Fast_onset_of_effect_of_budesonide/formoterol_versus_salmeterol/fluticasone_and_salbutamol_in_patients_with_chronic_obstructive_pulmonary_disease_and_reversible_airway_obstruction_ L2 - https://doi.org/10.1111/j.1440-1843.2007.01132.x DB - PRIME DP - Unbound Medicine ER -