Comparative Evaluation of Fixed Dose Combinations of Fluticasone/ Formoterol and Budesonide/ Formoterol in Patients of Mild - Moderate Bronchial Asthma

The prevalence of asthma is rising worldwide with 10 – 12% adults and 15% children affected presently. It can have a considerable impact on the quality of life of both, patients an d their caregivers. Fixed dose combination of Inhaled corticosteroids (ICS) like fluticasone and budesonide and long acting beta 2 agonists (LABAs) in the form of metered dose inhaler (MDI) are synergistic in action and provide effective control in asthma. Objectives: In the present study, two ICS & LABA combinations i.e. fluticasone/ formoterol and budesonide/ formoterol were compared, both administered through a metered dose inhaler (MDI) with a spacer, for achieving and maintaining asthma control, improving symptoms, pulmonary function tests and q uality of life in patients of mild to moderate bronchial asthma. Methods : It was a prospective, open - label, randomized, parallel study conducted for a total duration of 12 weeks. The parameters used to compare the two MDIs at 0, 6 and 12 weeks were: a. Pulmo nary function tests – FEV 1 , PEFR b. Asthma control scoring (according to the GINA definition of "control") c. Standardized Asthma Quality of Life Questionnaire [AQLQ(S)] d. Adverse effect profile Results : By the end of 12 weeks, asthma control was similarly achieved among the two groups except that fluticasone/ formoterol was significantly better than budesonide/ formoterol in reducing the need for rescue bronchodilator use (p= 0.000) and in improving daytime symptoms at 6 weeks (p= 0.000) . Fluticasone/ formot erol at 6 weeks, significantly increased the percent predicted PEFR (p= 0.007) and percent improvement in AQLQ(S) score (p= 0.006) in comparison to budesonide/ formoterol. Conclusion: Fixed dose combination MDIs containing fluticasone/ formoterol and budeso nide/ formoterol are effective in elevating pulmonary functions, controlling & relieving symptoms and revamping the quality of life in patients of bronchial asthma. Fluticasone/ formoterol were better in providing a more rapid and greater improvement in pe rcent predicted PEFR, controlling daytime symptoms for a longer time and reducing the need for rescue therapy. Both the treatments were well tolerated.