Budesonide/formoterol therapy reduces inflammation and airway remodeling
MedWire News: Combination therapy with budesonide and formoterol benefits asthma patients by reducing inflammation and limiting airway remodeling, study results suggest.
Writing in the Journal of Allergy and Clinical Immunology, Paul O'Byrne (McMaster University, Hamilton, Ontario, Canada) and team explain: “Combining inhaled corticosteroids with long-acting β2-agonists results in improved asthma symptom control and fewer asthma exacerbations compared with those seen after inhaled corticosteroids alone.
“However, there are limited data as to whether these beneficial effects are due to enhanced anti-inflammatory actions or whether such combination therapies affect airway remodeling in patients with asthma.”
To investigate, the researchers compared the effects of inhaled budesonide/formoterol combination therapy, inhaled budesonide alone, and inhaled placebo on allergen-induced airway responses, airway inflammation, and airway remodeling in 14 patients with mild asthma who were aged an average of 26 years.
The participants were randomly assigned to receive one of the three treatment regimens for 11 days each, separated by washout periods of at least 21 days.
Sputum samples taken before and after each treatment revealed that combination treatment reduced allergen-induced eosinophilia by a significantly greater extent than budesonide alone, while placebo had no significant effect on eosinophilia.
Bronchial biopsies also revealed that combination therapy, but not budesonide monotherapy, significantly attenuated both the increase in submucosal tissue myofibroblast numbers and the decrease in percentage smooth muscle area resulting from allergen inhalation.
O'Byrne and team conclude: “The mechanism by which budesonide/formoterol combination therapy exerts its clinically beneficial effects appears to relate to increased anti-inflammatory activity and attenuation of aspects of airway remodeling in asthma.”
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By Mark Cowen