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*

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

33 Citaten (Scopus)


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.

Originele taal-2English
Pagina's (van-tot)282-290
Aantal pagina's9
TijdschriftCOPD: Journal of Chronic Obstructive Pulmonary Disease
Nummer van het tijdschrift5
StatusPublished - okt.-2008

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