Evidence map›Paper›PMID 40360225›Full record

Trial reportThe Korean journal of internal medicine2025

Comparison of extrafine and non-extrafine inhaled corticosteroids/long-acting β2-agonists as maintenance and reliever therapy in asthma: a randomized open-label crossover trial.

Sang Pyo Lee, Sang Min Lee, Sung-Yoon Kang

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in The Korean journal of internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Sang Pyo LeeDivision of Pulmonology and Allergy, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
Sang Min LeeDivision of Respiratory Disease and Allergy, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
Sung-Yoon KangDivision of Pulmonology and Allergy, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.

Funding

Gachon University Gil Medical Center FRD 2021-13Korean Association of Internal Medicine
6 · The paper itself

Abstract

BACKGROUND/

aimsAsthma is characterized by chronic inflammation. Inhaled corticosteroids (ICS) remain the cornerstone of anti-inflammatory therapy, targeting both the large and small airways.

methodsThis randomized open-label crossover trial included 30 patients receiving step 3 inhaled medication according to the Global Initiative for Asthma (GINA). Patients received beclomethasone/formoterol (BDP/F) for maintenance and reliever therapy for 6 weeks, followed by budesonide/formoterol (BUD/F) for 6 weeks, or vice versa, with a 4-week washout period in between. Assessments at each visit included the Asthma Control Test (ACT), Asthma Control Questionnaire, Quality of Life Questionnaire for Adult Korean Asthmatics, and pulmonary function test. The primary endpoint was the change in forced expiratory flow between 25% and 75% of vital capacity (FEF25-75% pred).

resultsTwenty-four patients (15 females, mean age 39.3 years) completed the study. The changes in FEF25-75% pred were comparable between BDP/F and BUD/F (5.79 ± 38.34 vs. -1.36 ± 14.93, p = 0.399). No significant differences were observed between the BDP/F and BUD/F groups in terms of improvement in asthma control or quality of life. However, in the subgroup of patients with positive methacholine bronchial provocation tests, BDP/F significantly improved ACT scores compared to BUD/F (0.92 ± 2.25 vs. -1.31 ± 3.04, p = 0.044).

conclusionOur study demonstrated that extrafine ICS treatment provided no significant advantage over non-extrafine ICS in improving small airway obstruction or overall asthma control in moderate asthma. This suggests that factors other than particle size may contribute to treatment outcomes.

Indexed as

Adrenal Cortex HormonesAdrenergic beta-2 Receptor AgonistsAnti-Asthmatic AgentsAsthmaBeclomethasoneBudesonide, Formoterol Fumarate Drug CombinationLungAdministration, InhalationAdultCross-Over StudiesFemaleForced Expiratory VolumeHumansMaleMiddle AgedQuality of LifeAdrenal Cortex HormonesAdrenergic beta-2 Receptor AgonistsAnti-Asthmatic AgentsBeclomethasoneBudesonide, Formoterol Fumarate Drug CombinationAsthmaBeclomethasoneBudesonideForced expiratory flow between 25% and 75% of vital capacityTreatment outcome

Identifiers

PMID40360225
PMCPMC12081104

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Registered trials

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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.