Anti-inflammatory Effects of Combined Budesonide/Formoterol in COPD Exacerbations

Erik Bathoorn, Jeroen J. W. Liesker, Dirkje S. Postma, Martin Boorsma, Eva Bondesson, Gerard H. Koeter, Henk F. Kauffman, Antoon J. M. van Oosterhout, Huib A. M. Kerstjens*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

31 Citations (Scopus)

Abstract

Systemic corticosteroids and additional short-acting beta 2-agonists are commonly used in exacerbations of chronic obstructive pulmonary disease (COPD). In this double-blind study, the combination of a high-dose inhaled corticosteroid with a rapid-onset long-acting beta 2-agonist was evaluated in the treatment of out-patient COPD exacerbations. The primary aim was to compare 14-day treatment effects of budesonide/formoterol to placebo on sputum eosinophils and, secondarily, on other indices of inflammation, forced expiratory flow in one second (FEV(1)), symptoms, health status, and adverse events. Forty-five patients not using steroids (37 male, 21/24 currentlex smoker, median packyears 38, age 65 years, FEV(1) 61% predicted), experiencing a COPD exacerbation, were treated at home with budesonide/formoterol (320/9 mu g 4 times daily), prednisolone (30 mg daily), or placebo for 14 days. Sputum eosinophils were significantly reduced by budesonide/formoterol (-57%) compared to placebo (+24%) (p = 0.01). Budesonide/formoterol reduced total symptom scores significantly (p = 0.01) compared to placebo. The increase in FEV(1) by 2 weeks of treatment with budesonide/formoterol (125 ml) was not significantly different from that of placebo (43 ml) (p = 0.07). Budesonide/formoterol treatment did not suppress morning serum cortisol compared to placebo (-16 %; p = 0.50). In conclusion, budesonide/formoterol reduces sputum eosinophils and improves symptoms in the treatment of out-patient COPD exacerbations.

Original languageEnglish
Pages (from-to)282-290
Number of pages9
JournalCOPD: Journal of Chronic Obstructive Pulmonary Disease
Volume5
Issue number5
DOIs
Publication statusPublished - Oct-2008

Keywords

  • Budesonide
  • Chronic obstructive pulmonary disease
  • Exacerbation
  • Formoterol Inflammation
  • Sputum induction
  • OBSTRUCTIVE PULMONARY-DISEASE
  • RANDOMIZED CONTROLLED-TRIAL
  • SHORT-TERM RESPONSE
  • AIRWAY INFLAMMATION
  • SPUTUM-EOSINOPHILIA
  • ORAL PREDNISOLONE
  • INHALED CORTICOSTEROIDS
  • NEBULIZED BUDESONIDE
  • CHRONIC-BRONCHITIS
  • ASTHMA

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