Effect of different asthma treatments on risk of cold-related exacerbations

Common colds often trigger asthma exacerbations. The present study compared cold-related severe exacerbations during budesonide/formoterol maintenance and reliever therapy, and different regimens of maintenance inhaled corticosteroids (ICS), with or without long-acting β(2)-agonists (LABA), and with...

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Veröffentlicht in:The European respiratory journal Jg. 38; H. 3; S. 584
Hauptverfasser: Reddel, H K, Jenkins, C, Quirce, S, Sears, M R, Bateman, E D, O'Byrne, P M, Humbert, M, Buhl, R, Harrison, T, Brusselle, G G, Thorén, A, Sjöbring, U, Peterson, S, Ostlund, O, Eriksson, G S
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England 01.09.2011
Schlagworte:
Adolescent
Adrenal Cortex Hormones - therapeutic use
Adult
Aged
Aged, 80 and over
Asthma - complications
Asthma - therapy
Budesonide - administration & dosage
Child
Child, Preschool
Common Cold - complications
Double-Blind Method
Ethanolamines - administration & dosage
Female
Formoterol Fumarate
Humans
Male
Middle Aged
Poisson Distribution
Respiratory Tract Infections - drug therapy
Retrospective Studies
Risk
Time Factors
ISSN:1399-3003, 1399-3003
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Zusammenfassung:Common colds often trigger asthma exacerbations. The present study compared cold-related severe exacerbations during budesonide/formoterol maintenance and reliever therapy, and different regimens of maintenance inhaled corticosteroids (ICS), with or without long-acting β(2)-agonists (LABA), and with as-needed short-acting β(2)-agonists (SABA) or LABA. Reported colds and severe exacerbations (defined by oral corticosteroid use and/or hospitalisation/emergency room visit) were assessed for 12,507 patients during 6-12 months of double-blind treatment. Exacerbations occurring ≤14 days after onset of reported colds were analysed by a Poisson model. The incidence of colds was similar across treatments. Asthma symptoms and reliever use increased during colds. Budesonide/formoterol maintenance and reliever therapy reduced severe cold-related exacerbations by 36% versus pooled comparators plus SABA (rate ratio (RR) 0.64; p=0.002), and for individual treatment comparisons, by 52% versus the same maintenance dose of ICS/LABA (RR 0.48; p<0.001); there were nonsignificant reductions versus higher maintenance doses of ICS or ICS/LABA (RR 0.83 and 0.72, respectively). As-needed LABA did not reduce cold-related exacerbations versus as-needed SABA (RR 0.96). Severe cold-related exacerbations were reduced by budesonide/formoterol maintenance and reliever therapy compared with ICS with or without LABA and with as-needed SABA. Subanalyses suggested the importance of the ICS component in reducing cold-related exacerbations. Future studies should document the cause of exacerbations, in order to allow identification of different treatment effects.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1399-3003
1399-3003
DOI:10.1183/09031936.00186510