LONDON, July 2 /PRNewswire/ -- Updated guidelines issued this week by the British Thoracic Society (BTS) and Scottish Intercollegiate Guidelines Network (SIGN) include the use of budesonide/formoterol in a single inhaler as rescue medication, in addition to its regular use as controller therapy, in selected adult patients poorly controlled at step 2 or selected adult patients with poorly controlled asthma at step 3(1).
The BTS/SIGN guidelines recognise the evidence supporting the efficacy of Symbicort(TM) (budesonide/formoterol) Maintenance And Reliever Therapy (Symbicort SMART(TM)) as rescue medication instead of a short-acting beta2 agonist (SABA) in selected adult patients poorly controlled at step 2 (above BDP 400mcg) or selected adult patients with poorly controlled asthma at step 3(1). Budesonide/formoterol is the only combination inhaler that has been recommended for this purpose within the revised guidelines as this management technique has not been investigated with other combination inhalers(1).
Commenting on the launch of the new guidelines, Doctor Kevin Gruffydd-Jones from the Universities of Bath and Aberdeen said:
The recent update in the BTS/SIGN pharmacology guidelines has reinforced and confirmed the position of Symbicort SMART in asthma management. The evidence has shown that in patients with persistent asthma, who are ineffectively controlled [at both step 2 and step 3 of the guidelines] Symbicort SMART used as both a maintenance and reliever therapy is an effective and simple treatment regime. When used in this way it has been shown to reduce exacerbations which may in turn result in reduced hospitalisations and AE visits.
The Symbicort Summary of Product Characteristics recommends the use of budesonide/formoterol for adults aged 18 years and older who are suitable for combination therapy, especially those with inadequate asthma control and in frequent need of reliever medication, as well as in patients who have had asthma exacerbations requiring medical interventions(2).
Symbicort SMART(R) was launched in the UK in June 2007. Patients take a regular dose consisting of the inhaled corticosteroid (ICS), budesonide and the LABA, formoterol, and additional inhalations, if required, to provide symptom relief and simultaneously improve control. As with other combination asthma therapies, Symbicort SMART is not licensed for regular prophylactic use before exercise(2).
Respiratory nurse consultant, Jane Scullion from Glenfield Hospital comments:
These updated guidelines are very important for those patients with asthma which is currently not well controlled. We have a key role to play in helping educate patients on the role of budesonide/formoterol in controlling symptoms and in helping them adjust to use of a combination inhaler in this way. Patients adhere to therapies that are simple and convenient to use and use of budesonide/formoterol in a single inhaler as rescue medication, in addition to its regular use as controller therapy can offer this convenience to patients
Notes to Editors
1. In 2006, about 1,200 people died from asthma - an average of three people per day or one person every seven hours(3)
2. With Symbicort SMART, patients receive a maintenance dose of Symbicort in line with normal practice to establish asthma control and take additional inhalations 'as required' of Symbicort if symptoms occur, to provide both rapid symptom relief and increased asthma control
3. Symbicort SMART has been shown to reduce asthma exacerbations and maintain similar daily asthma control at a lower overall drug load compared with higher traditional fixed dosing ICS/LABA combination plus SABA(4)
4. Patients suitable for the Symbicort SMART treatment approach would no longer require a separate bronchodilator for the treatment of asthma symptoms
5. The updated BTS/SIGN guidelines include Symbicort SMART as follows:
In selected adult patients at step 3 who are poorly controlled or in selected adult patients at step 2 (above BDP 400 mcg/day who are poorly controlled), the use of budesonide/formoterol in a single inhaler as rescue medication instead of a short-acting Î²2 agonist, in addition to its regular use as controller therapy has been shown to be an effective treatment regime. When this management option is introduced the total regular dose of daily inhaled corticosteroids should not be decreased. The regular maintenance dose of inhaled steroids may be budesonide 200 mcg twice daily or budesonide 400 mcg twice daily. Patients taking rescue budesonide/ formoterol once a day or more should have their treatment reviewed. Careful education of patients about the specific issues around this management strategy is required
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(1) British Thoracic Society (BTS) and Scottish Intercollegiate Guidelines Network (SIGN) Guidelines. British Guideline on the Management of Asthma, 2009. http://www.sign.ac.uk/pdf/sign101.pdf (Full Guidance Document)
(2) Summary of Product Characteristics (SmPC) 2008
(3) Asthma UK. For journalists: key facts statistics
(4) Kuna P et al. Effect of budesonide/formoterol maintenance and reliever therapy on asthma exacerbations Int J Clin Pract 2007;61: 725-736
For further information, please contact:
Suzie Collett, Respiratory Communications Manager, AstraZeneca: +44-(0)1582-836653
Maria Parnham, Head of Medical Education and PR, Brand(x) Communications: +44-(0)208-987-6700
For further information, please contact: Suzie Collett, Respiratory Communications Manager, AstraZeneca: +44-(0)1582-836653. Maria Parnham, Head of Medical Education and PR, Brand(x) Communications: +44-(0)208-987-6700