Symbicort in steroid-dependent asthma: reduction of oral steroids requirements

Objective: to study the ability of inhaled Symbicort to reduce daily oral steroids (OS) requirements in patients with severe steroid-dependent asthma. Methods: 16 patients with severe steroid-dependent asthma were included into the study (5 males, 11 females, mean age 53 ± 8 years, mean dose of OS 10.9 ± 5.2 mg / day, mean OS treatment duration 9.3 ± 4.1 years, mean FEV1 59.3 ± 15.1%). All patients received Symbicort administered by means of a multidose poder inhaler 4.5 / 160 mkg 2 inhalations twice daily, every 2 weeks patients underwent controlled OS reduction on the basis of predetermined asthma stability criteria. Results: OS was eliminated or reduced in 14 patients (87.5 %), the OS dose was reduced to 3.3 ± 6.8 mg / day (р < 0.001). At the end of 12 weeks of Symbicort therapy FEV 1 and FVC increased by 18.6 % and 8.9 %, respectively. Daytime and nighttime asthma symptom severity scores improved in average by 1 point (р < 0.001). The number of inhalations of short-acting β 2 -agonists reduced from 3.4 ± 1.7 to 1.5 ± 1.3 puffs / day (р < 0.001). Statistically and clinically significant improvements were seen in all 4 domains of quality of life scores (AQLQ) (р < 0.001). The level of NOex reduced significantly form 18.6 ± 11.4 ppb at baseline to 7.9 ± 2.8 ppb after 12 weeks (р = 0.001). The side effects of OS were reduced to the end of study. Conclusion: in patients with severe steroid-dependent asthma therapy with Symbicort allows to eliminate or reduce OS therapy with improved lung function, improved daytime and nighttime asthma symptoms, improved asthma-specific quality of life, reduction of short-acting β 2 -agonists use and reduction of side effects of OS.