Trial reportPrimary care respiratory journal : journal of the General Practice Airways Group2012
Budesonide/formoterol maintenance and reliever therapy in primary care asthma management: effects on bronchial hyperresponsiveness and asthma control.
Trial report in Primary care respiratory journal : journal of the General Practice Airways Group, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 5 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Combination fixed-dose beta agonist and steroid inhaler as required for adults or children with mild asthma.The Cochrane database of systematic reviews · 2021Pooled it
- Comparative effectiveness of long term drug treatment strategies to prevent asthma exacerbations: network meta-analysis.BMJ (Clinical research ed.) · 2014Pooled it
- Combination formoterol and budesonide as maintenance and reliever therapy versus current best practice (including inhaled steroid maintenance), for chronic asthma in adults and children.The Cochrane database of systematic reviews · 2013Pooled it
- Intermittent versus daily inhaled corticosteroids for persistent asthma in children and adults.The Cochrane database of systematic reviews · 2013Pooled it
- Canadian Thoracic Society 2012 guideline update: diagnosis and management of asthma in preschoolers, children and adults.Canadian respiratory journalGuideline
- Budesonide/formoterol maintenance and reliever therapy in Asian patients (aged ≥16 years) with asthma: a sub-analysis of the COSMOS study.Clinical drug investigation · 2012Trial
- Inhaled Corticosteroid/Long-Acting βAdvances in therapy · 2026Review
- Article
- 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group.The Journal of allergy and clinical immunology · 2020Review
- Combining genomewide association study and lung eQTL analysis provides evidence for novel genes associated with asthma.Allergy · 2016Article
- Guidelines for diagnosis and management of bronchial asthma: Joint ICS/NCCP (I) recommendations.Lung India : official organ of Indian Chest Society · 2015Article
- Single inhaler maintenance and reliever therapy (SMART) in general practice asthma management: where are we?Primary care respiratory journal : journal of the General Practice Airways Group · 2012Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe management of asthma has changed since the introduction of budesonide/formoterol (Symbicort®) as both maintenance and reliever therapy (SMART). SMART and its effects on bronchial hyperresponsiveness (BHR) have not been studied in primary care.
aimsTo compare the effects of SMART and guideline-driven usual care (UC) on BHR and clinical asthma severity in primary care practice.
methodsPatients with mild-to-moderate stable asthma were randomised to receive SMART treatment (n=54) (budesonide/formoterol 80/4.5 μg Turbuhaler®, two puffs once daily and extra inhalations as needed) or UC treatment (n=48) for 12 months. Diary data, Asthma Control Questionnaire scores, forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF) measurements were collected during run-in and after 1, 3, 6, and 12 months of treatment. BHR, measured as the dose of histamine provoking a fall in FEV1 of 20% (PD20-histamine), was determined at randomisation and after 12 months.
resultsOne hundred and two patients with asthma participated in the study. The change in PD20-histamine during the study was not significantly different between the SMART and UC groups (p=0.26). The mean inhaled corticosteroid (ICS) dose was 326 μg beclomethasone dipropionate (BDP) equivalents/day (95% CI 254 to 399) with SMART, which was significantly lower (p<0.0001) than the mean ICS dose with UC treatment (798 μg BDP equivalents/day (95% CI 721 to 875). Morning and evening PEF values increased significantly with SMART treatment compared with UC; FEV1, symptoms and asthma control did not differ.
conclusionsDespite a 59% lower dose of ICS, BHR and other clinical outcomes remained stable during SMART treatment while PEF values improved.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.