Protocol: Influence of Budesonide and Budesonide/Formoterol on Asthma Control in Smoking Asthmatic Adults



Louis-Philippe Boulet*, 1, Francine Deschesnes1, Simone Chaboillez2, Catherine Lemière2
1 Centre de recherche de institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
2 Hôpital du Sacré-Cœur de Montréal, Université de Montréal, Canada


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© Boulet et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725, Chemin Sainte-Foy, Québec, Qc, GlV 4G5, Canada; Tel: 418-656-4747; Fax: 418-656-4762; E-mail lpboulet@med.ulaval.ca


Abstract

Rationale:

A reduced response to inhaled corticosteroids (ICS) has been reported in smoking asthmatic patients but the effects of other medications remain to be evaluated in this population.

Subjects and Methods:

We evaluated the effects of a combined therapy of budesonide 200 µg twice daily and formoterol 6 µg twice daily compared with budesonide 200 µg twice daily alone on asthma control questionnaire (ACQ), asthma quality of life questionnaire (AQLQ- Juniper), pulmonary function and airway inflammation, in a cross-over randomized double-blind study with treatment periods of two months separated by a one-month wash-out period. Seventeen smoking and 22 non-smoking patients not using inhaled corticosteroids with slightly uncontrolled mild asthma completed the study.

Results:

ACQ and AQLQ scores were similar in both groups at baseline and improved similarly after treatments. β2-agonist use was higher in smokers, regardless of the treatment received (p=0.03), as it was on baseline (p=0.003). Smokers treated with budesonide/formoterol showed an increase in the number of asthma episodes (intercurrent asthma symptoms, p=0.016) while non-smoking subjects had a significant decrease in these episodes (p=0.009). No difference was found between smokers and non-smokers in regard to post-treatment airway inflammatory parameters.

Conclusions:

No significant differences were found between smoking and non-smoking subjects with mild asthma in regard to clinical changes in asthma control, pulmonary function and airway inflammation following a 2-month treatment period with budesonide or the association of budesonide and formoterol for a period of 2 months. This should be further explored in larger groups of subjects.

Keywords: Asthma, formoterol, budesonide, smoking..