Asthma Clinical Trial
Official title:
As Needed Budesonide/Formoterol Combination Versus Regular Budesonide/Formoterol Combination Plus as Needed Terbutaline in Mild-Moderate Persistent Asthma
Study No.001 about Budesonide/Formoterol use in ASthMA sponsored by Agenzia Italiana del FArmaco (Italian Drug Agency) (AIFA-ASMA-BF-001) The aim of the study is to verify whether asthma not controlled by low doses inhaled corticosteroids, thus in need for step up therapy, can be equally controlled by guidelines recommended regular bid treatment with long acting beta agonist/inhaled corticosteroid (ICS/LABA) combination or the symptom driven use of an ICS/LABA combination in the absence of maintenance therapy. The study is designed to be able to evaluate the non inferiority of regular placebo plus prn inhaled budesonide/formoterol (experimental treatment) versus regular, twice daily 160/4.5 mcg inhaled budesonide/formoterol combination plus prn inhaled terbutaline (guidelines recommended treatment).
Asthma is a problem worldwide, with an estimated 300 million affected individuals.There is
evidence that asthma prevalence has been increasing in the last decades in some countries,
including Italy. Analyses of the cost of asthma lead to conclude that the burden of the
disease depend on the extent to which exacerbations are avoided since emergency treatment is
more expensive than regular treatment.
Based on solid evidence, international guidelines recommend regular treatment with low dose
ICS for mild persistent asthma and treatment with combination therapy [low dose ICS plus
long-acting beta2-agonists (LABA)] for patients with asthma not controlled by low doses ICS
alone. Recent studies have undermined the axiom that treatment with ICS must be regular to
achieve and maintain asthma control, as equivalent control has been obtained either with prn
use of an inhaled combination of a short acting beta2 agonist (SABA) and an ICS, or with a
short course of 10 days high dose ICS at the start of exacerbations. In moderate-severe
asthma regularly treated with inhaled ICS/LABA combination, the symptom-driven use of the
same inhaled ICS/LABA combination as reliever is superior to the symptom-driven use of SABA
or LABA alone.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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