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Symbicort matches usual care and cuts steroid dose

Patients with asthma taking Symbicort maintenance and reliever therapy have equally good outcomes as those on guideline-driven usual care, despite receiving a 59% lower dose of inhaled steroids, finds a study from the Netherlands.


Some 102 patients with mild to moderate asthma were randomised to receive SMART treatment (combination inhaler budesonide/formoterol  both as maintenance and reliever therapy) - or usual care, based on Global Initiative for Asthma  guidelines, for 12 months.

The average dose of inhaled steroid was 326?g beclomethasone dipropionate equivalents per day with SMART, compared with 798?g in usual care.

There was no significant difference in bronchial hyperresponsiveness, asthma control or symptoms between the groups. Peak expiratory flow measurements improved over 12 months in those on SMART treatment, with morning PEF increasing from 441 l/min to 458 l/min, compared with a fall from 449 l/min to 447 l/min in the usual care group.

Study lead Dr Roland Riemersma, a GP in Appingedam, The Netherlands said SMART therapy ‘appears to be a well-tolerated and beneficial concept for the management of patients with mild-to-moderate asthma in primary care'.

Current SIGN guidance says SMART therapy is effective in some adult patients with poorly controlled asthma.

Prim Care Respir J, 2011, published online 21 October

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