Effects of budesonide/formoterol combination therapy versus budesonide alone on airway dimensions in asthma
Respirology,  Clinical Article

Hoshino M et al. – Budesonide/formoterol combination therapy is more effective than budesonide alone for reducing airway wall thickness and inflammation in individuals with asthma.

Methods
  • Fifty asthmatic patients were randomized to treatment with budesonide/formoterol (200/6 µg, two inhalations bd) or budesonide (200 µg, two inhalations bd) for 24 weeks.
  • Airway dimensions were assessed using a validated computed tomography technique, and airway wall area (WA) corrected for body surface area (BSA), percentage WA (WA%), wall thickness/Ösquare root BSA, and luminal area (Ai)/BSA at the right apical segmental bronchus, were measured.
  • The percentage of eosinophils in induced sputum, pulmonary function, and Asthma Quality of Life Questionnaires (AQLQ) were also evaluated.

Results
  • There were significantly greater decreases in WA/BSA (P < 0.05), WA% (P < 0.001) and wall thickness/square root BSA (P < 0.05), and increases in Ai/BSA (P < 0.05), in subjects treated with budesonide/formoterol compared with those treated with budesonide.
  • The reduction in sputum eosinophils and increase in per cent of predicted forced expiratory volume in 1 s (FEV1%) were greater for subjects treated with budesonide/formoterol compared with those treated with budesonide alone.
  • In the budesonide/formoterol group, the changes in WA% were significantly correlated with changes in sputum eosinophils and FEV1% (r = 0.84 and r = 0.64, respectively).
  • There were improvements in the AQLQ scores after treatment with budesonide/formoterol.

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