Once-daily dosing with budesonide/formoterol compared with twice-daily budesonide/formoterol and once-daily budesonide in adults with mild to moderate asthma

SummaryAdherence to maintenance therapy is often poor in patients with asthma. Simplifying dosing regimens has the potential to improve both adherence and asthma-related morbidity. In this 12-week, randomized, double-blind, double-dummy, parallel-group study, 617 patients with mild to moderate persistent asthma (mean forced expiratory volume in 1s [FEV1] 78.5% predicted) who were not optimally controlled on inhaled corticosteroids (200–500μg/day) were randomized to once-daily budesonide/formoterol (80/4.5μg, 2 inhalations in the evening), twice-daily budesonide/formoterol (80/4.5μg, 1 inhalation), or a corresponding dose of budesonide once-daily (200μg, 1 inhalation in the evening). All patients received budesonide (100μg twice daily) during a 2-week run-in. Changes in mean morning peak expiratory flow (PEF) were similar for od budesonide/formoterol (23.4l/min) and twice-daily budesonide/formoterol (24.1l/min), and both were greater than with budesonide (5.5l/min; both P<0.001). Evening PEF, symptom-free days, reliever-free days, and asthma control days were improved with budesonide/formoterol therapy vs. budesonide (P