The effect of adding long acting beta 2 agonists to inhaled corticosteroids versus increasing dose of inhaled corticosteroids in improving asthma control

To asthmatic patients with moderate to severe persistent asthma, two main treatment options are recommended: The combination of a long-acting inhaled β2-agonist with inhaled corticosteroids or the use of a higher dose of inhaled corticosteroids. The aim of this study was to evaluate which drug option is more favorable. Patients and methods: This study included 60 asthmatic patients uncontrolled on low doses of ICSs. They were randomized into two groups. Group (1): 30 patients received twice daily inhaled formetrol and budesonide in a dose of 12 mcg and 400 mcg, respectively. Group (2): 30 patients received two fold the previous dose of budesonide 800 mcg/BID alone. A comparative study was carried out at Outpatient Chest Clinic of Fayoum Hospital University for a period of 24 weeks using the spirometric data of patients of the two groups before and after treatment. Results: Results showed that the combination therapy of inhaled formetrol and budesonide is modestly more effective in the reduction of symptoms and in improving the lung functions than with a higher dose of budesonide alone. Conclusion: Adding formetrol in a dose of 12 μg plus budesonide in a dose 400 μg b.i.d. is more favorable in treatment of asthma than a higher dose of budesonide (800 μg b.i.d)