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Acute asthma intervention: insights from the STAY study
1Firestone Institute for Respiratory Health, St Joseph's Healthcare, Department of Medicine, McMaster University, Hamilton, Ontario, Canada. obyrnep@mcmaster.ca
The Journal of Allergy and Clinical Immunology
|April 25, 2007
Summary
For moderate to severe asthma, using budesonide/formoterol as both maintenance and reliever medication significantly reduces exacerbations and improves symptoms. This combination therapy offers a more effective asthma management strategy for patients of all ages.
Area of Science:
- Pulmonology
- Pharmacology
Background:
- Inhaled corticosteroids combined with long-acting beta(2)-agonists improve asthma control in some patients.
- However, fluctuating asthma control and exacerbations persist in many individuals.
Purpose of the Study:
- To evaluate if budesonide/formoterol as a reliever medication, replacing short-acting beta(2)-agonists, could provide rapid symptom relief and reduce asthma exacerbations.
- To compare budesonide/formoterol as maintenance and reliever ( mantenimiento y alivio) versus budesonide plus terbutaline as reliever in moderate to severe asthma.
Main Methods:
- The STAY study randomized 2760 asthma patients (ages 4-80) into three groups.
- Treatments included budesonide twice daily (bid) with terbutaline as reliever, budesonide/formoterol bid with terbutaline as reliever, or budesonide/formoterol bid as both maintenance and reliever.
- Children (4-11 years) received a once-daily maintenance dose.
Main Results:
- Budesonide/formoterol as maintenance and reliever significantly reduced severe exacerbation risk by 45%–47% compared to the other two treatment arms.
- This approach also led to improvements in asthma symptoms, nighttime awakenings, and lung function across all age groups.
- Subsequent research indicated that both components of the budesonide/formoterol combination are necessary for this beneficial effect.
Conclusions:
- Budesonide/formoterol used as both maintenance and reliever therapy is a highly effective strategy for managing moderate to severe asthma.
- This treatment approach offers significant reductions in severe exacerbations and improvements in patient-reported outcomes and lung function.
- The efficacy of budesonide/formoterol as maintenance and reliever therapy is dependent on the synergistic action of both budesonide and formoterol.
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