Effects of budesonide/formoterol combination therapy versus budesonide alone on airway dimensions in asthma

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 CT technique, and airway wall area (WA) corrected for body surface area (BSA), percentage wall area (WA%), wall thickness (T)/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 T/BSA (P < 0.05), and increases in Ai/BSA (P < 0.05), in subjects treated with budesonide/formoterol compared to those treated with budesonide.
• The reduction in sputum eosinophils and increase in FEV1% were greater for subjects treated with budesonide/formoterol compared to 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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