Budesonide/formoterol via Turbuhaler (R) versus formoterol via Turbuhaler (R) in patients with moderate to severe chronic obstructive pulmonary disease: Phase III multinational study results

作者：Fukuchi Yoshinosuke^*; Samoro Ronnie; Fassakhov Rustem; Taniguchi Hiroyuki; Ekelund Jan; Carlsson Lars Goran; Ichinose Masakazu

来源：Respirology, 2013, 18(5): 866-873.

DOI：10.1111/resp.12090

• budesonide
• formoterol
• chronic obstructive pulmonary disease
• exacerbation
• formoterol
• lung function

Background and objective The efficacy and tolerability of budesonide/formoterol versus formoterol in patients with moderate to severe chronic obstructive pulmonary disease (COPD) was evaluated. Methods In this randomized, double-blind, parallel-group, phase III study (NCT01069289), patients with moderate to severe COPD for 2 years received either budesonide/formoterol 160/4.5g two inhalations twice daily via Turbuhaler (R) or formoterol 4.5g two inhalations twice daily via Turbuhaler (R) for 12 weeks. Salbutamol was available as reliever medication. Primary outcome variable: change from baseline to average during treatment in pre-dose forced expiratory volume in 1s (FEV1). Results One thousand two hundred ninety-three patients were randomized (budesonide/formoterol n=636; formoterol n=657). Both budesonide/formoterol and formoterol increased pre-dose FEV1 versus baseline (improvements of 4.6% and 1.5% over baseline, respectively), with the increase from baseline being significantly greater with budesonide/formoterol versus formoterol (budesonide/formoterol:formoterol ratio 1.032; 95% confidence interval: 1.013-1.052; P=0.0011). The budesonide/formoterol group had a significantly prolonged time to first exacerbation versus the formoterol group (hazard ratio: 0.679; 95% confidence interval: 0.507-0.909; P=0.0094) and significantly greater improvements in many secondary outcome measures. Both treatments were well tolerated; the incidence and type of adverse events were similar: most commonly reported (budesonide/formoterol vs formoterol): COPD (8.0% vs 9.4%) and nasopharyngitis (5.5% vs 4.9%). Conclusions Budesonide/formoterol 160/4.5g two inhalations twice daily was effective and well tolerated in patients with moderate to severe COPD, offering benefits over formoterol alone in terms of improved lung function and reduced risk of exacerbation.

• 出版日期2013-7