ERS 2022:Maintenance and Reliever Therapy with Budesonide/Formoterol versus Fixed Dose Fluticasone/Salmeterol in Patients with COPD

Asthma exacerbations are significantly reduced by maintenance and reliever therapy (MART) with inhaled corticosteroid (ICS)/formoterol. Therefore, the authors investigated its efficacy compared to fixed-dose fluticasone/salmeterol in COPD patients. In a multicenter study, patients with COPD and ≥1 exacerbation in the previous 2 years were randomized to receive either open-label MART (Spiromax® budesonide/formoterol 160/4.5 µg two inhalations twice daily + 1 prn) or fixed-dose therapy (Diskus® fluticasone propionate/salmeterol combination (FSC) 500/50 µg one inhalation twice daily + salbutamol 100 μg prn) for one year.

The following results were reported:

  • There was no significant difference in the exacerbation rate between MART and FSC.
  • There were no differences in lung function parameters or health status, except for a trend toward increased hyperinflation with FSC and higher COPD Assessment Test scores with MART.
  • MART significantly reduced the total administered ICS dose as compared to FSC.
  • Similar proportions of patients reported adverse events and pneumonia.

The study concluded that budesonide/formoterol MART is similarly effective as fluticasone/salmeterol fixed-dose therapy in moderate-severe COPD patients at a lower daily inhaled corticosteroid dosage.

European Respiratory Society (ERS) International Congress 2022, 3rd-6th Sept. 2022, Barcelona