Date - 22 June 2005

Source - Drugs in Context 2005; 1(4): Symbicort® - Asthma p189

Author - Dr Eleanor Bull

Symbicort^® is a single combined formulation of the inhaled corticosteroid, budesonide, and the long-acting ß2-adrenoceptor agonist (ß2-agonist), formoterol. The combined administration of these agents is currently recommended in asthma patients in whom moderate doses of inhaled corticosteroids are failing to provide adequate control. Whether the optimised asthma control that results from coadministration of both agents is a result of synergistic drug-drug interactions or simply the improved convenience of a single inhaler regimen remains unclear. Clinical studies have shown that Symbicort is as effective as budesonide and formoterol administered via separate inhalers and is more effective than higher doses of budesonide monotherapy. By limiting the dose of inhaled corticosteroid, Symbicort may help to minimise the long-term systemic safety concerns related to the prolonged use of inhaled corticosteroids. Patient-controlled adjustable Symbicort adjustable maintenance dosing regimens are associated with similar, and for some markers of lung function, greater levels of asthma control compared with fixed-dose regimens, and at a lower overall dose. Several comparative studies with Seretide^® - the single inhaler formulation of fluticasone propionate and salmeterol - have suggested some advantages of the adjustable maintenance dosing regimen of Symbicort, particularly with regard to a lower frequency of severe exacerbations. Both combinations provide significant improvements in asthma control compared with their respective monotherapies.

Keywords: Asthma, budesonide, formoterol, Symbicort^®, combination therapy