| Asthma control can be maintained after fixed-dose, budesonide/ formoterol combination inhaler therapy is stepped down from medium to low dose. | |
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MedLine Citation:
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PMID: 23093793 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In cases using a budesonide/formoterol combination inhaler, many patients are started on fixed-dose treatment at 640/18μg (4 puffs) daily, but there are no guidelines yet regarding the step-down method when control has been maintained. METHODS: Patients with moderate asthma treated with either budesonide 400μg and salmeterol 100μg (GINA step3 group) or salmeterol/fluticasone 250 at 2 puffs (GINA step4 group) were enrolled and started on therapy of budesonide/formoterol 4 puffs. Thereafter, step-down to 2 puffs was performed if either of the following criteria was met at 8-week intervals: fractional exhaled nitric oxide (FeNO) ≤ 28 ppb plus asthma control test (ACT) score ≥ 22, or ACT score ≥ 24 at 3 consecutive visits regardless of FeNO level. Thereafter, changes in ACT score, the number of acute exacerbations and reliever use, and FeNO level were monitored through 48th week. RESULTS: Fifty-one patients, 27 in step3 group and 24 in step4 group, underwent step-down. ACT scores and the number of reliever use remained stable in both groups even after step-down. In contrast, FeNO levels increased gradually in step4 group, whereas in the step3 group they increased immediately after step-down. Step-down was considered to be safely performed because the numbers of reliever use and those of moderate or more severe exacerbations during the 48-week period has not changed significantly compared to before step-down. CONCLUSIONS: If complete control of asthma, not only of clinical symptoms but also airway inflammation, is achieved by 3-6 months of fixed-dose budesonide/formoterol 4 puffs/day, it should be possible to safely perform step-down to 2 puffs/day. |
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Authors:
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Masayuki Hojo; Tomonori Mizutani; Motoyasu Iikura; Satoshi Hirano; Nobuyuki Kobayashi; Haruhito Sugiyama |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2012-10-25 |
Journal Detail:
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Title: Allergology international : official journal of the Japanese Society of Allergology Volume: 62 ISSN: 1440-1592 ISO Abbreviation: Allergol Int Publication Date: 2013 Mar |
Date Detail:
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Created Date: 2013-02-26 Completed Date: 2013-04-19 Revised Date: 2013-06-11 |
Medline Journal Info:
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Nlm Unique ID: 9616296 Medline TA: Allergol Int Country: Japan |
Other Details:
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Languages: eng Pagination: 91-8 Citation Subset: IM |
Affiliation:
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Division of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan. mhojo@hosp.ncgm.go.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Inhalation Adrenergic beta-2 Receptor Agonists / administration & dosage* Adult Aged Aged, 80 and over Anti-Inflammatory Agents / administration & dosage* Asthma / drug therapy* Budesonide / administration & dosage* Drug Combinations Ethanolamines / administration & dosage* Female Humans Male Middle Aged Nebulizers and Vaporizers Nitric Oxide / analysis Risk Factors Spirometry Treatment Outcome Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-2 Receptor Agonists; 0/Anti-Inflammatory Agents; 0/Drug Combinations; 0/Ethanolamines; 10102-43-9/Nitric Oxide; 51333-22-3/Budesonide; 5ZZ84GCW8B/formoterol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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