Inflammatory and functional effects of increasing asthma treatment with formoterol or double dose budesonide

Autor(es)

Menezes, Marcelo B. ; Teixeira, Antonio L. ^[1] ; Terra Filho, Joao ; Vianna, Elcio O. ^[2]

Afiliação do(s) autor(es)

^[1] Univ Fed Minas Gerais, Sch Med, Dept Internal Med, Minas Gerais - Brazil

^[2] Univ Sao Paulo, Med Sch Ribeirao Preto, Dept Med, Div Pulm, BR-14048900 Ribeirao Preto, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: RESPIRATORY MEDICINE; v. 102, n. 10, p. 1385-1391, OCT 2008.
• Citações Web of Science: 3

Resumo

Adding a long-acting beta(2)-agonist to inhaled corticosteroids (ICS) for asthma treatment is better than increasing ICS dose in improving clinical status, although there is no consensus about the impact of this regimen on inflammation. In this double-blind, randomized, parallel group study, asthmatics with moderate to severe disease used budesonide (400 mcg/day) for 5 weeks (run-in period); then they were randomized to use budesonide (800 mcg/day - BUD group) or budesonide plus formoterol (400 mcg and 24 mcg/day, respectively - FORMO group) for 9 weeks (treatment period). Home PEF measurements, symptom daily reporting, spirometry, sputum induction (for differential cell counts and sputum cell cultures), and hypertonic saline bronchial challenge test were performed before and after treatments. TNF-alpha, IL-4 and eotaxin-2 levels in the sputum and cell culture supernatants were determined. Morning and night PEF values increased in the FORMO group during the treatment period (p < 0.01), from 435 +/- 162 to 489 +/- 169 and 428 +/- 160 to 496 +/- 173 L/min, respectively. The rate of exacerbations in the FORMO group was lower than in the BUD group (p < 0.05). Neutrophil counts in sputum increased in both groups (p < 0.05) and leukocyte viability after 48 h-culture increased in the FORMO group (p < 0.05). No other parameter changed significantly in either group. This study showed that adding formoterol to budesonide improved home PEF and provided protection from exacerbations, although increase of leukocyte viability in cell culture may be a matter of concern and needs further investigation. (C) 2008 Elsevier Ltd. All rights reserved. (AU)

• Processo FAPESP: 04/00706-1 - Comparação entre budesonida 800 MCG ao dia e budesonida 400 MCG associada a formoterol 24 MCG ao dia no tratamento de asma moderada
• Beneficiário: Marcelo Bezerra de Menezes
• Modalidade de apoio: Bolsas no Brasil - Doutorado Direto