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Effect of different asthma treatments on risk of cold-related exacerbations

HK Reddel, C Jenkins, S Quirce, MR Sears, ED Bateman, PM O'Byrne, M Humbert, R Buhl, T Harrison, Guy Brusselle UGent, et al. (2011) EUROPEAN RESPIRATORY JOURNAL. 38(3). p.584-593
abstract
Common colds often trigger asthma exacerbations. The present study compared cold-related severe exacerbations during budesonide/formoterol maintenance and reliever therapy, and different regimens of maintenance inhaled corticosteroids (ICS), with or without long-acting beta(2)-agonists (LABA), and with as-needed short-acting beta(2)-agonists (SABA) or LABA. Reported colds and severe exacerbations (defined by oral corticosteroid use and/or hospitalisation/emergency room visit) were assessed for 12,507 patients during 6-12 months of double-blind treatment. Exacerbations occurring <= 14 days after onset of reported colds were analysed by a Poisson model. The incidence of colds was similar across treatments. Asthma symptoms and reliever use increased during colds. Budesonide/formoterol maintenance and reliever therapy reduced severe cold-related exacerbations by 36% versus pooled comparators plus SABA (rate ratio (RR) 0.64; p=0.002), and for individual treatment comparisons, by 52% versus the same maintenance dose of ICS/LABA (RR 0.48; p < 0.001); there were nonsignificant reductions versus higher maintenance doses of ICS or ICS/LABA (RR 0.83 and 0.72, respectively). As-needed LABA did not reduce cold-related exacerbations versus as-needed SABA (RR 0.96). Severe cold-related exacerbations were reduced by budesonide/formoterol maintenance and reliever therapy compared with ICS with or without LABA and with as-needed SABA. Subanalyses suggested the importance of the ICS component in reducing cold-related exacerbations. Future studies should document the cause of exacerbations, in order to allow identification of different treatment effects.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
Asthma, drug therapy, exacerbations, respiratory tract infections, AIRWAY EPITHELIAL-CELLS, BETA(2)-ADRENOCEPTOR AGONISTS, INHALED CORTICOSTEROIDS, COMBINATION THERAPY, RELIEVER THERAPY, CONTROLLED-TRIAL, RHINOVIRUS, BUDESONIDE, BUDESONIDE/FORMOTEROL, MAINTENANCE
journal title
EUROPEAN RESPIRATORY JOURNAL
Eur. Resp. J.
volume
38
issue
3
pages
584 - 593
Web of Science type
Article
Web of Science id
000294458300018
JCR category
RESPIRATORY SYSTEM
JCR impact factor
5.895 (2011)
JCR rank
3/48 (2011)
JCR quartile
1 (2011)
ISSN
0903-1936
DOI
10.1183/09031936.00186510
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2025940
handle
http://hdl.handle.net/1854/LU-2025940
date created
2012-02-10 10:22:41
date last changed
2016-12-19 15:39:43
@article{2025940,
  abstract     = {Common colds often trigger asthma exacerbations. The present study compared cold-related severe exacerbations during budesonide/formoterol maintenance and reliever therapy, and different regimens of maintenance inhaled corticosteroids (ICS), with or without long-acting beta(2)-agonists (LABA), and with as-needed short-acting beta(2)-agonists (SABA) or LABA. 
Reported colds and severe exacerbations (defined by oral corticosteroid use and/or hospitalisation/emergency room visit) were assessed for 12,507 patients during 6-12 months of double-blind treatment. Exacerbations occurring {\textlangle}= 14 days after onset of reported colds were analysed by a Poisson model. 
The incidence of colds was similar across treatments. Asthma symptoms and reliever use increased during colds. Budesonide/formoterol maintenance and reliever therapy reduced severe cold-related exacerbations by 36\% versus pooled comparators plus SABA (rate ratio (RR) 0.64; p=0.002), and for individual treatment comparisons, by 52\% versus the same maintenance dose of ICS/LABA (RR 0.48; p {\textlangle} 0.001); there were nonsignificant reductions versus higher maintenance doses of ICS or ICS/LABA (RR 0.83 and 0.72, respectively). As-needed LABA did not reduce cold-related exacerbations versus as-needed SABA (RR 0.96). 
Severe cold-related exacerbations were reduced by budesonide/formoterol maintenance and reliever therapy compared with ICS with or without LABA and with as-needed SABA. Subanalyses suggested the importance of the ICS component in reducing cold-related exacerbations. Future studies should document the cause of exacerbations, in order to allow identification of different treatment effects.},
  author       = {Reddel, HK and Jenkins, C and Quirce, S and Sears, MR and Bateman, ED and O'Byrne, PM and Humbert, M and Buhl, R and Harrison, T and Brusselle, Guy and Thor{\'e}n, A and Sj{\"o}bring, U and Peterson, S and {\"O}stlund, O and Eriksson, GS},
  issn         = {0903-1936},
  journal      = {EUROPEAN RESPIRATORY JOURNAL},
  keyword      = {Asthma,drug therapy,exacerbations,respiratory tract infections,AIRWAY EPITHELIAL-CELLS,BETA(2)-ADRENOCEPTOR AGONISTS,INHALED CORTICOSTEROIDS,COMBINATION THERAPY,RELIEVER THERAPY,CONTROLLED-TRIAL,RHINOVIRUS,BUDESONIDE,BUDESONIDE/FORMOTEROL,MAINTENANCE},
  language     = {eng},
  number       = {3},
  pages        = {584--593},
  title        = {Effect of different asthma treatments on risk of cold-related exacerbations},
  url          = {http://dx.doi.org/10.1183/09031936.00186510},
  volume       = {38},
  year         = {2011},
}

Chicago
Reddel, HK, C Jenkins, S Quirce, MR Sears, ED Bateman, PM O’Byrne, M Humbert, et al. 2011. “Effect of Different Asthma Treatments on Risk of Cold-related Exacerbations.” European Respiratory Journal 38 (3): 584–593.
APA
Reddel, H., Jenkins, C., Quirce, S., Sears, M., Bateman, E., O’Byrne, P., Humbert, M., et al. (2011). Effect of different asthma treatments on risk of cold-related exacerbations. EUROPEAN RESPIRATORY JOURNAL, 38(3), 584–593.
Vancouver
1.
Reddel H, Jenkins C, Quirce S, Sears M, Bateman E, O’Byrne P, et al. Effect of different asthma treatments on risk of cold-related exacerbations. EUROPEAN RESPIRATORY JOURNAL. 2011;38(3):584–93.
MLA
Reddel, HK, C Jenkins, S Quirce, et al. “Effect of Different Asthma Treatments on Risk of Cold-related Exacerbations.” EUROPEAN RESPIRATORY JOURNAL 38.3 (2011): 584–593. Print.