Fast onset of effect of budesonide/formoterol versus salmeterol/fluticasone and salbutamol in patients with chronic obstructive pulmonary disease and reversible airway obstruction

Abstract

Budesonide/formoterol has an onset of bronchodilatory effect in patients with COPD and reversible airway obstruction that is faster than salmeterol/fluticasone and similar to salbutamol.

Once-daily indacaterol 75 µg in moderate- to-severe COPD: results of a Phase IV study assessing time until patients’ perceived onset of effect

“…However, dyspnea (measured using the Transition Dyspnea Index) was significantly improved with indacaterol 75 μg versus placebo in one study but not in the other 1. Disparities between different assessments were also observed in a study by Lindberg et al11 that used the same instrument employed in our study to evaluate budesonide/formoterol, salmeterol/fluticasone, salbutamol, and placebo in patients with COPD. In this trial, significant objective differences were recorded in lung function between active treatments, but patient perceptions of the onset of action were similar.…”

“…Of note, 61% of placebo recipients answered “yes” when asked whether their medication was working (versus 81%–84% for the active treatments). As well as raising concerns regarding the sensitivity of the questionnaire, Lindberg et al11 noted that patients may have been in a “steady state” with regard to symptoms, and many may have been relatively asymptomatic, thus compromising the ability of the instrument to assess treatment effects.…”

“…The primary variable was time (in minutes) to patient’s perception of onset of effect, defined as the first time point (5 minutes, 7.5 minutes, 10 minutes, 15 minutes, 20 minutes, 30 minutes, 40 minutes, 50 minutes, and 60 minutes postdose) that the patient responded “yes” to the self-administered statement “I feel that the drug is working in improving my breathing.” This tool was chosen because it was used to assess perceptions of onset of action in a previous study of patients with COPD,11 and a validated instrument was not available for this purpose. Exploratory variables included change in FEV 1 and change in percent predicted FEV 1 from predose to postdose (60−75 minutes postdose), as well as patient’s global satisfaction with onset of effect and patient’s expectation of treatment adherence (both administered after completion of the 60 minute perception of onset of effect questionnaire; Table 1).…”

“…Bronchodilator treatments in COPD have demonstrated an acute improvement in spirometric indices,10 and there is a potential for patient perception of onset of effect to improve adherence to treatment. Although patient-reported assessment of time until the perception of onset of effect based on a questionnaire has been described in asthma and COPD,11,12 overall there is limited information on this topic in the published literature.…”

A Role of Epidemiological Studies in Pulmonology

“…Так, если принять активность изопреналина за 100, то относительная активность формотерола составит 90, а салметерола только 38 [31]. По сравнению с Серетидом использование Симби-корта не только обеспечивает более высокие показа-тели ОФВ1 [32], но и в большей степени влияет на гиперинфляцию у больных ХОБЛ [33]. Кроме того, фракция респирабельных частиц при использова-нии Турбухалера существенно выше по сравнению с Мультидиском (44,0 и 20,4 % соответственно) [34].…”