Randomised trial comparing as-needed versus regular treatment with formoterol in patients with persistent asthma

Area of Science:

• Respiratory Medicine
• Clinical Pharmacology
• Asthma Management

Background:

• Asthma requires effective long-term control strategies.
• Inhaled corticosteroids are standard, but add-on therapies are often needed.
• Formoterol, a long-acting beta-agonist, can be used regularly or as needed.

Purpose of the Study:

• To compare the efficacy of as-needed versus twice-daily inhaled formoterol in patients with mild to moderate asthma.
• To assess asthma exacerbation rates in two different formoterol dosing regimens.

Main Methods:

• A randomized, open-label, 12-week study.
• 359 patients with inadequately controlled asthma received inhaled formoterol either as needed or twice daily (4 puffs/day).
• The primary endpoint was the number of patients experiencing asthma exacerbations.

Main Results:

• No statistically significant difference in asthma exacerbations between the as-needed (3.95%) and twice-daily (3.45%) formoterol groups.
• Patients in the as-needed group used significantly less formoterol (1.5 puffs/day less).
• Total beta-2 agonist use was lower in the as-needed group, and both regimens were well tolerated.

Conclusions:

• As-needed inhaled formoterol is as effective as regular twice-daily dosing for managing asthma exacerbations.
• As-needed formoterol use results in markedly lower overall drug consumption.
• Both treatment schedules demonstrated good tolerability in patients with mild to moderate asthma.