Budesonide/formoterol combination in COPD: a US perspective
Amir Sharafkhaneh1,2, Amarbir S Mattewal1, Vinu M Abraham1, Goutham Dronavalli1, Nicola A Hanania1
1Section of Pulmonary, Critical Care Medicine and Sleep Medicine, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA; 2Section of Pulmonary, Critical Care Medicine and Sleep Medicine, Medical Care Line, Michael E DeBakey VA Medical Center, Houston, Texas, USA
Abstract: Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease of the lung caused primarily by exposure to cigarette smoke. Clinically, it presents with progressive cough, sputum production, dyspnea, reduced exercise capacity, and diminished quality of life. Physiologically, it is characterized by the presence of partially reversible expiratory airflow limitation and hyperinflation. Pathologically, COPD is a multicomponent disease characterized by bronchial submucosal mucous gland hypertrophy, bronchiolar mucosal hyperplasia, increased luminal inflammatory mucus, airway wall inflammation and scarring, and alveolar wall damage and destruction. Management of COPD involves both pharmacological and nonpharmacological approaches. Bronchodilators and inhaled corticosteroids are recommended medications for management of COPD especially in more severe disease. Combination therapies containing these medications are now available for the chronic management of stable COPD. The US Food and Drug Administration, recently, approved the combination of budesonide/formoterol (160/4.5 µg; Symbicort™, AstraZeneca, Sweden) delivered via a pressurized meter dose inhaler for maintenance management of stable COPD. The combination also is delivered via dry powder inhaler (Symbicort™ and Turbuhaler™, AstraZeneca, Sweden) but is not approved for use in the United States. In this review, we evaluate available data of the efficacy and safety of this combination in patients with COPD.
Keywords: inhaled steroid, bronchodilator, ß2-agonist, lung function, quality of life, COPD exacerbations
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