Limits...
A smarter way to manage asthma with a combination of a long-acting beta(2)-agonist and inhaled corticosteroid.

Selroos O - Ther Clin Risk Manag (2007)

Bottom Line: Clinical results show that Symbicort SMART prolongs the time to the first severe asthma exacerbation, reduces the rate of exacerbations, and maintains day-to-day asthma control at a reduced load of corticosteroids (inhaled plus systemic) when compared with higher fixed maintenance doses of combination inhalers.Symbicort SMART is also easier for the patient as only one inhaler is required.The positive results with Symbicort SMART can be explained by the early as-needed use on the inhaled corticosteroid component, which puts out the early flames of inflammation, together with the interaction between the beta(2)-agonist, formoterol, and the inhaled corticosteroid, budesonide.

View Article: PubMed Central - PubMed

Affiliation: SEMECO AB (Selroos Medical Consulting).

ABSTRACT
Symbicort SMART(R) (Symbicort Maintenance and Reliever Therapy) represents a new and unique way of treating patients with moderate-to-severe asthma, ie, those patients who require combination treatment with an inhaled corticosteroid and a long-acting inhaled beta(2)-agonist. Symbicort SMART enables patients to use only one inhaler, the budesonide-formoterol combination inhaler, for both maintenance and reliever therapy. The maintenance dose is adjustable, but should be a minimum of two doses per day which can be administered as two doses once daily or as one dose twice daily. It is important that the temporary reliever medication includes not only a bronchodilator but also an antiinflammatory drug because worsening of asthma includes not only more airway narrowing, but also an increase in airway inflammation. The Symbicort SMART concept therefore ensures that the patient gets an antiinflammatory drug at the time of the first signs of asthma worsening. Clinical results show that Symbicort SMART prolongs the time to the first severe asthma exacerbation, reduces the rate of exacerbations, and maintains day-to-day asthma control at a reduced load of corticosteroids (inhaled plus systemic) when compared with higher fixed maintenance doses of combination inhalers. Symbicort SMART consequently offers a more effective and simple approach to asthma management for physicians and patients. Symbicort SMART is also easier for the patient as only one inhaler is required. The positive results with Symbicort SMART can be explained by the early as-needed use on the inhaled corticosteroid component, which puts out the early flames of inflammation, together with the interaction between the beta(2)-agonist, formoterol, and the inhaled corticosteroid, budesonide.

No MeSH data available.


Related in: MedlinePlus

The cumulative rate of severe exacerbations in a study comparing budesonide-formoterol as maintenance and reliever therapy (Symbicort SMART®) compared with salmeterol-fluticasone in adjustable dosing and salbutamol used as needed. Symbicort SMART reduced the exacerbation rate by 22% (p < 0.01). Copyright © 2005. Reproduced with permission from Vogelmeier C, D’Urzo A, Pauwels R, et al. 2005. Budesonide-formoterol maintenance and reliever therapy: an effective asthma treatment option? Eur Respir J, 26:819–28.Abbreviations: BUD/FORM, budesonide-formoterol; SAL/FP, salmeterol-fluticasone.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC1936317&req=5

fig2: The cumulative rate of severe exacerbations in a study comparing budesonide-formoterol as maintenance and reliever therapy (Symbicort SMART®) compared with salmeterol-fluticasone in adjustable dosing and salbutamol used as needed. Symbicort SMART reduced the exacerbation rate by 22% (p < 0.01). Copyright © 2005. Reproduced with permission from Vogelmeier C, D’Urzo A, Pauwels R, et al. 2005. Budesonide-formoterol maintenance and reliever therapy: an effective asthma treatment option? Eur Respir J, 26:819–28.Abbreviations: BUD/FORM, budesonide-formoterol; SAL/FP, salmeterol-fluticasone.

Mentions: To reflect clinical practice, another 12-month study compared Symbicort SMART with salmeterol-fluticasone in adjustable doses plus salbutamol as needed. Adjustment of salmeterol-fluticasone was performed by changing inhalers based on actual asthma control as assessed by the physician (Vogelmeier et al 2005). The Symbicort SMART concept, as per the above studies, resulted in a 25% lower risk of having a first asthma exacerbation (p = 0.01) (Figure 2). The cumulative risk of having a severe exacerbation was 22% lower in the Symbicort SMART group (p < 0.05) with 0.24 events per patient per year in the Symbicort SMART group compared with 0.31 events in the salmeterol-fluticasone group. The difference in risk of having a severe exacerbation was true for all types of exacerbations based on unscheduled visits initiated by the patients, hospitalizations, and emergency room treatments as well as courses of oral steroids. The difference was statistically significant even when unscheduled visits as a cause for exacerbations were excluded. The overall mean use of ICS was very similar in the two groups: budesonide 562 µg as maintenance dose and additional 91 µg per day as needed (total daily dose 653 µg) compared with 583 µg per day of fluticasone. Oral steroids had to be given for 1980 days in the Symbicort SMART group compared with 2978 days in the salmeterol-fluticasone group. Thus a clear oral steroid sparing effect was seen in the Symbicort SMART study group. Asthma control was evaluated using the asthma control questionnaire, ACQ5 (Juniper et al 1999). No statistically significant difference was found between the treatment groups.


A smarter way to manage asthma with a combination of a long-acting beta(2)-agonist and inhaled corticosteroid.

Selroos O - Ther Clin Risk Manag (2007)

The cumulative rate of severe exacerbations in a study comparing budesonide-formoterol as maintenance and reliever therapy (Symbicort SMART®) compared with salmeterol-fluticasone in adjustable dosing and salbutamol used as needed. Symbicort SMART reduced the exacerbation rate by 22% (p < 0.01). Copyright © 2005. Reproduced with permission from Vogelmeier C, D’Urzo A, Pauwels R, et al. 2005. Budesonide-formoterol maintenance and reliever therapy: an effective asthma treatment option? Eur Respir J, 26:819–28.Abbreviations: BUD/FORM, budesonide-formoterol; SAL/FP, salmeterol-fluticasone.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC1936317&req=5

fig2: The cumulative rate of severe exacerbations in a study comparing budesonide-formoterol as maintenance and reliever therapy (Symbicort SMART®) compared with salmeterol-fluticasone in adjustable dosing and salbutamol used as needed. Symbicort SMART reduced the exacerbation rate by 22% (p < 0.01). Copyright © 2005. Reproduced with permission from Vogelmeier C, D’Urzo A, Pauwels R, et al. 2005. Budesonide-formoterol maintenance and reliever therapy: an effective asthma treatment option? Eur Respir J, 26:819–28.Abbreviations: BUD/FORM, budesonide-formoterol; SAL/FP, salmeterol-fluticasone.
Mentions: To reflect clinical practice, another 12-month study compared Symbicort SMART with salmeterol-fluticasone in adjustable doses plus salbutamol as needed. Adjustment of salmeterol-fluticasone was performed by changing inhalers based on actual asthma control as assessed by the physician (Vogelmeier et al 2005). The Symbicort SMART concept, as per the above studies, resulted in a 25% lower risk of having a first asthma exacerbation (p = 0.01) (Figure 2). The cumulative risk of having a severe exacerbation was 22% lower in the Symbicort SMART group (p < 0.05) with 0.24 events per patient per year in the Symbicort SMART group compared with 0.31 events in the salmeterol-fluticasone group. The difference in risk of having a severe exacerbation was true for all types of exacerbations based on unscheduled visits initiated by the patients, hospitalizations, and emergency room treatments as well as courses of oral steroids. The difference was statistically significant even when unscheduled visits as a cause for exacerbations were excluded. The overall mean use of ICS was very similar in the two groups: budesonide 562 µg as maintenance dose and additional 91 µg per day as needed (total daily dose 653 µg) compared with 583 µg per day of fluticasone. Oral steroids had to be given for 1980 days in the Symbicort SMART group compared with 2978 days in the salmeterol-fluticasone group. Thus a clear oral steroid sparing effect was seen in the Symbicort SMART study group. Asthma control was evaluated using the asthma control questionnaire, ACQ5 (Juniper et al 1999). No statistically significant difference was found between the treatment groups.

Bottom Line: Clinical results show that Symbicort SMART prolongs the time to the first severe asthma exacerbation, reduces the rate of exacerbations, and maintains day-to-day asthma control at a reduced load of corticosteroids (inhaled plus systemic) when compared with higher fixed maintenance doses of combination inhalers.Symbicort SMART is also easier for the patient as only one inhaler is required.The positive results with Symbicort SMART can be explained by the early as-needed use on the inhaled corticosteroid component, which puts out the early flames of inflammation, together with the interaction between the beta(2)-agonist, formoterol, and the inhaled corticosteroid, budesonide.

View Article: PubMed Central - PubMed

Affiliation: SEMECO AB (Selroos Medical Consulting).

ABSTRACT
Symbicort SMART(R) (Symbicort Maintenance and Reliever Therapy) represents a new and unique way of treating patients with moderate-to-severe asthma, ie, those patients who require combination treatment with an inhaled corticosteroid and a long-acting inhaled beta(2)-agonist. Symbicort SMART enables patients to use only one inhaler, the budesonide-formoterol combination inhaler, for both maintenance and reliever therapy. The maintenance dose is adjustable, but should be a minimum of two doses per day which can be administered as two doses once daily or as one dose twice daily. It is important that the temporary reliever medication includes not only a bronchodilator but also an antiinflammatory drug because worsening of asthma includes not only more airway narrowing, but also an increase in airway inflammation. The Symbicort SMART concept therefore ensures that the patient gets an antiinflammatory drug at the time of the first signs of asthma worsening. Clinical results show that Symbicort SMART prolongs the time to the first severe asthma exacerbation, reduces the rate of exacerbations, and maintains day-to-day asthma control at a reduced load of corticosteroids (inhaled plus systemic) when compared with higher fixed maintenance doses of combination inhalers. Symbicort SMART consequently offers a more effective and simple approach to asthma management for physicians and patients. Symbicort SMART is also easier for the patient as only one inhaler is required. The positive results with Symbicort SMART can be explained by the early as-needed use on the inhaled corticosteroid component, which puts out the early flames of inflammation, together with the interaction between the beta(2)-agonist, formoterol, and the inhaled corticosteroid, budesonide.

No MeSH data available.


Related in: MedlinePlus