Objective: To review the available scientific evidence behind the use of budesonide/formoterol for maintenance and reliever therapy for the outpatient control of asthma exacerbation. Data sources: The Medline database was searched using the terms albuterol, asthma, budesonide for- moterol fumarate drug combination, exacerbation, formoterol fumarate, guidelines, long acting beta 2 agonist, randomized control trial, reliever, and Symbicort. Articles cited in the 2016 GINA guidelines were also assessed for relevance and included in this literature review. Methods: Studies evaluating the clinical efficacy of budesonide/formoterol for maintenance and reliever therapy in patients ≥ 12 years old with diagnosed asthma were included. Acceptable study designs included RCTs, retrospective analyses, prospective analyses, and post hoc analyses published in English no earlier than 2002. All titles and abstracts were initially reviewed for relevance. Articles remaining after initial review were divided equally among authors for in-depth review and data extraction. The quality of evidence of each study was assessed using the 2011 Oxford Levels of Evidence table. Results: Fourteen of the nineteen articles supported using budesonide/formoterol as both a reliever and maintenance medication. Four articles found no difference in time to first severe asthma exacerbation and one article found no significant difference in number of asthma control days. Conclusions: The evidence of this review supports the use of budesonide/formoterol as both a mainte- nance and reliever therapy in adults with uncontrolled, persistent asthma. SMART (Single Maintenance and Reliever Therapy) improves a number of asthma control measures, deeming it a favorable option for inclusion in future NHLBI guideline revisions
Walek, Stephanie; McDonald, Ashley; Wolff, Robert.
An Investigation Into the Evidence Behind Budesonide/Formoterol (Symbicort®) Usage in the Outpatient Setting as Reliever Medication for Asthma.
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