Document Detail

Inflammatory and functional effects of increasing asthma treatment with formoterol or double dose budesonide.
MedLine Citation:
PMID:  18632258     Owner:  NLM     Status:  MEDLINE    
Adding a long-acting beta(2)-agonist to inhaled corticosteroids (ICS) for asthma treatment is better than increasing ICS dose in improving clinical status, although there is no consensus about the impact of this regimen on inflammation. In this double-blind, randomized, parallel group study, asthmatics with moderate to severe disease used budesonide (400 mcg/day) for 5 weeks (run-in period); then they were randomized to use budesonide (800 mcg/day--BUD group) or budesonide plus formoterol (400 mcg and 24 mcg/day, respectively--FORMO group) for 9 weeks (treatment period). Home PEF measurements, symptom daily reporting, spirometry, sputum induction (for differential cell counts and sputum cell cultures), and hypertonic saline bronchial challenge test were performed before and after treatments. TNF-alpha, IL-4 and eotaxin-2 levels in the sputum and cell culture supernatants were determined. Morning and night PEF values increased in the FORMO group during the treatment period (p<0.01), from 435+/-162 to 489+/-169 and 428+/-160 to 496+/-173 L/min, respectively. The rate of exacerbations in the FORMO group was lower than in the BUD group (p<0.05). Neutrophil counts in sputum increased in both groups (p<0.05) and leukocyte viability after 48 h-culture increased in the FORMO group (p<0.05). No other parameter changed significantly in either group. This study showed that adding formoterol to budesonide improved home PEF and provided protection from exacerbations, although increase of leukocyte viability in cell culture may be a matter of concern and needs further investigation.
Marcelo B Menezes; Antônio L Teixeira; João Terra Filho; Elcio O Vianna
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-07-15
Journal Detail:
Title:  Respiratory medicine     Volume:  102     ISSN:  1532-3064     ISO Abbreviation:  Respir Med     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-02     Completed Date:  2009-05-06     Revised Date:  2013-06-11    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1385-91     Citation Subset:  IM    
Department of Medicine, University of S. Paulo Medical School at Ribeirão Preto, Brazil.
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MeSH Terms
Administration, Inhalation
Adrenergic beta-Agonists / therapeutic use
Asthma / drug therapy*,  immunology,  physiopathology
Bronchodilator Agents / administration & dosage*,  therapeutic use
Budesonide / administration & dosage*,  therapeutic use
Cytokines / immunology
Double-Blind Method
Drug Administration Schedule
Drug Therapy, Combination
Ethanolamines / administration & dosage*,  therapeutic use
Glucocorticoids / therapeutic use
Lung / physiopathology
Middle Aged
Peak Expiratory Flow Rate
Treatment Failure
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Bronchodilator Agents; 0/Cytokines; 0/Ethanolamines; 0/Glucocorticoids; 51333-22-3/Budesonide; 5ZZ84GCW8B/formoterol

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