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Asthma
Conclusion less use compared with a fixed-dose regimen. It also appears that
Studies have established that the efficacy between fixed doses of there may be a minimum threshold to be reached in adjustable
budesonide plus formoterol and fluticasone plus salmeterol in maintenance dosing in order to prevent exacerbations. Indeed,
reducing the rate of exacerbations and improving asthma there is a need for more trials evaluating the role of adjustable
symptoms and lung function is similar, while also demonstrating dosing before any clear conclusions can be drawn. ■
comparable tolerability. In spite of the varying reports on efficacy
data, adjustable- and fixed-dose budesonide plus formoterol pMDI
Jean Bousquet is a Professor of Pulmonary Medicine
or DPI and fixed-dose fluticasone plus salmeterol DPI were well-
at the University of Montpellier. For many years he
tolerated with no apparent unprecedented safety concerns. proposed the concept of airway remodelling in asthma
Although more real-life studies are needed to understand where
and studied this process. He then continued to examine
the relationships between asthma and rhinitis as a
adjustable-dose budesonide plus formoterol stands in terms of
co-morbidity, particularly in severely affected patients.
efficacy compared with fixed doses of the ICS plus LABA He is Chairman of the World Health Organization (WHO)
combination therapies, the studies have provided new insight into
Global Alliance against Chronic Respiratory Diseases
(GARD), Director of the WHO Collaborating Centre for
the use of adjustable doses in the treatment of asthma. Adjustable
Asthma and Rhinitis in Montpellier and Vice Chairmnan of the EU-funded network of
dosing may provide greater cost-effectiveness, and some patients excellence GA
2
LEN (Global Allergy and Asthma European Network).
may benefit from facing less exposure to the medication through
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14 EUROPEAN RESPIRATORY DISEASE
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