10 micrograms combination treatment in patients with persistent asthma previously receiving medium-dose inhaled corticosteroids.

Allergy and asthma proceedings : the official journal of regional and state allergy societies 2010 Jul 30; In press

Nathan R, Nolte H, Pearlman D

Asthma is a heterogeneous condition characterized by reduced lung function, chronic inflammation, and periodic asthma deteriorations. This study was performed to evaluate the effect of mometasone furoate (MF)/formoterol (F) combination, 200/10 micrograms, administered twice daily (b.i.d.) on asthma deteriorations and pulmonary function in patients with asthma uncontrolled on medium-dose inhaled corticosteroid (ICS). After 2- to 3-week open-label run-in with MF 200 micrograms b.i.d., patients (greater than or equal to 12 years)were randomized to 26 weeks of treatment with MF/F 200/10 micrograms, MF 200 micrograms, F 10 micrograms, or placebo b.i.d. Coprimary endpoints were time to first asthma deterioration (MF/F versus F) and bronchodilation, assessed by the area under the curve of the change in forced expiratory volume in 1 second 0-12 hours (FEV1 AUC 0-12h; MF/F versus MF). A total of 781 patientswere randomized. Treatment with MF/F 200/10 micrograms reduced asthma deteriorations and clinically judged deteriorations (i.e., deterioration resulting in emergency treatment, hospitalization, or treatment with additional excluded asthma medication [i.e., systemic corticosteroids]). The proportion of patients experiencing asthma deteriorations was MF/F, 30.4%; MF, 33.9%; F, 54.0%; placebo, 55.6% (p less than 0.001, MF/F versus F and placebo). There was a sixfold reduction in clinically judged deteriorations with MF/F versus F and placebo (p less than 0.001). Lung function improved more rapidly with MF/F than MF andplacebo. Mean change from baseline FEV1 AUC 0-12h at week 12 was MF/F, 11.7% versus MF, 5.7%; F, 8.5%; and placebo,3.9% (p less than 0.001). Treatment-related AEs were rare and similar across groups. Treatment with MF/F 200/10 micrograms was effective inreducing the risk of asthma deteriorations. MF/F was safe and provided rapid and sustained bronchodilation in patients with asthma.

Keywords: mometasone formoterol asthma