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Effect of different asthma treatments on risk of cold-related exacerbations

Reddel, H. K.; Jenkins, C.; Quirce, S.; Sears, M. R.; Bateman, E. D.; O'Byrne, P. M.; Humbert, M.; Buhl, R.; Harrison, T. and Brusselle, G. G., et al. (2011) In European Respiratory Journal 38(3). p.584-593
Abstract
Common colds often trigger asthma exacerbations. The present study compared cold-related severe exacerbations during budesonide/formoterol maintenance and reliever therapy, and different regimens of maintenance inhaled corticosteroids (ICS), with or without long-acting beta(2)-agonists (LABA), and with as-needed short-acting beta(2)-agonists (SABA) or LABA. Reported colds and severe exacerbations (defined by oral corticosteroid use and/or hospitalisation/emergency room visit) were assessed for 12,507 patients during 6-12 months of double-blind treatment. Exacerbations occurring <= 14 days after onset of reported colds were analysed by a Poisson model. The incidence of colds was similar across treatments. Asthma symptoms and reliever use... (More)
Common colds often trigger asthma exacerbations. The present study compared cold-related severe exacerbations during budesonide/formoterol maintenance and reliever therapy, and different regimens of maintenance inhaled corticosteroids (ICS), with or without long-acting beta(2)-agonists (LABA), and with as-needed short-acting beta(2)-agonists (SABA) or LABA. Reported colds and severe exacerbations (defined by oral corticosteroid use and/or hospitalisation/emergency room visit) were assessed for 12,507 patients during 6-12 months of double-blind treatment. Exacerbations occurring <= 14 days after onset of reported colds were analysed by a Poisson model. The incidence of colds was similar across treatments. Asthma symptoms and reliever use increased during colds. Budesonide/formoterol maintenance and reliever therapy reduced severe cold-related exacerbations by 36% versus pooled comparators plus SABA (rate ratio (RR) 0.64; p=0.002), and for individual treatment comparisons, by 52% versus the same maintenance dose of ICS/LABA (RR 0.48; p < 0.001); there were nonsignificant reductions versus higher maintenance doses of ICS or ICS/LABA (RR 0.83 and 0.72, respectively). As-needed LABA did not reduce cold-related exacerbations versus as-needed SABA (RR 0.96). Severe cold-related exacerbations were reduced by budesonide/formoterol maintenance and reliever therapy compared with ICS with or without LABA and with as-needed SABA. Subanalyses suggested the importance of the ICS component in reducing cold-related exacerbations. Future studies should document the cause of exacerbations, in order to allow identification of different treatment effects. (Less)
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published
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keywords
Asthma, drug therapy, exacerbations, respiratory tract infections
in
European Respiratory Journal
volume
38
issue
3
pages
584 - 593
publisher
Eur Respiratory Soc
external identifiers
  • wos:000294458300018
  • scopus:80053086068
ISSN
1399-3003
DOI
10.1183/09031936.00186510
language
English
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yes
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d6acc34b-968d-43ce-8e39-993d8259460a (old id 2187023)
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2011-11-01 07:53:02
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@article{d6acc34b-968d-43ce-8e39-993d8259460a,
  abstract     = {Common colds often trigger asthma exacerbations. The present study compared cold-related severe exacerbations during budesonide/formoterol maintenance and reliever therapy, and different regimens of maintenance inhaled corticosteroids (ICS), with or without long-acting beta(2)-agonists (LABA), and with as-needed short-acting beta(2)-agonists (SABA) or LABA. Reported colds and severe exacerbations (defined by oral corticosteroid use and/or hospitalisation/emergency room visit) were assessed for 12,507 patients during 6-12 months of double-blind treatment. Exacerbations occurring &lt;= 14 days after onset of reported colds were analysed by a Poisson model. The incidence of colds was similar across treatments. Asthma symptoms and reliever use increased during colds. Budesonide/formoterol maintenance and reliever therapy reduced severe cold-related exacerbations by 36% versus pooled comparators plus SABA (rate ratio (RR) 0.64; p=0.002), and for individual treatment comparisons, by 52% versus the same maintenance dose of ICS/LABA (RR 0.48; p &lt; 0.001); there were nonsignificant reductions versus higher maintenance doses of ICS or ICS/LABA (RR 0.83 and 0.72, respectively). As-needed LABA did not reduce cold-related exacerbations versus as-needed SABA (RR 0.96). Severe cold-related exacerbations were reduced by budesonide/formoterol maintenance and reliever therapy compared with ICS with or without LABA and with as-needed SABA. Subanalyses suggested the importance of the ICS component in reducing cold-related exacerbations. Future studies should document the cause of exacerbations, in order to allow identification of different treatment effects.},
  author       = {Reddel, H. K. and Jenkins, C. and Quirce, S. and Sears, M. R. and Bateman, E. D. and O'Byrne, P. M. and Humbert, M. and Buhl, R. and Harrison, T. and Brusselle, G. G. and Thoren, A. and Sjobring, U. and Peterson, S. and Ostlund, O. and Eriksson, Göran},
  issn         = {1399-3003},
  keyword      = {Asthma,drug therapy,exacerbations,respiratory tract infections},
  language     = {eng},
  number       = {3},
  pages        = {584--593},
  publisher    = {Eur Respiratory Soc},
  series       = {European Respiratory Journal},
  title        = {Effect of different asthma treatments on risk of cold-related exacerbations},
  url          = {http://dx.doi.org/10.1183/09031936.00186510},
  volume       = {38},
  year         = {2011},
}