While the Global Asthma Initiative (GINA) and the National Asthma Education and Prevention Program recommended the use of ICS (inhaled steroid)-formoterol rather than SABA (short-acting beta agonist) alone, a meta-analysis study supporting this was released.
As a result of the analysis, both ICS-formoterol or ICS-SABA were effective in reducing asthma exacerbations and improving asthma control compared to SABA monotherapy, and in particular, ICS-formoterol emerged as the optimal combination as it caused fewer severe exacerbations than ICS-SABA.
The results of a comparative study on the effectiveness of inhalants for asthma conducted by researchers including Daniel G. Rayner of McMaster University in Canada were published in the international journal JAMA on the 28th (doi:10.1001/jama.2024.22700).
A meta-analysis study showed that both ICS-Formoterol or ICS-SABA are effective in reducing asthma exacerbations and improving asthma control compared to SABA monotherapy.
In the treatment of asthma, it is important to manage symptoms and reduce the underlying inflammation of the disease. To this end, adding ICS to SABA monotherapy or ICS-formoterol combination therapy combining formoterol, which has short-acting and long-lasting effects, is attempted.
The Global Asthma Initiative (GINA) and the National Asthma Education and Prevention Program recommend the use of ICS-formoterol over SABA alone, but the relative benefits of ICS-formoterol and ICS-SABA remain unclear.
Researchers conducted randomized trials evaluating SABA monotherapy, ICS with formoterol, and ICS plus SABA (combined or using separate inhalers) from January 1, 2020, to September 27, 2024, based on the MEDLINE, Embase, and Central databases. I chose a clinical trial.
A systematic review and network meta-analysis was conducted on a total of 27 randomized clinical trials including 50,496 adult and pediatric patients.
The main outcomes are a 5-item questionnaire related to asthma symptom control (0 to 6 points, lower scores indicate better asthma control), asthma-related quality of life (1 to 7 points, higher scores indicate better quality of life), and severe exacerbations. Risk was assessed by risk of serious side effects.
The analysis results showed that compared to SABA alone, the likelihood of severe exacerbation was reduced by 35% (RR 0.65) for ICS-formoterol and by 16% (RR 0.84) for ICS-SABA.
When comparing the improvement in asthma control with SABA alone, the total RR improvement score for ICS-formoterol was 1.07 and the total RR improvement score for ICS-SABA was 1.09, showing that both drugs containing ICS showed improved asthma control.
Meanwhile, when indirectly compared with ICS-SABA, ICS-formoterol was associated with fewer severe exacerbations (RR 0.78).
Compared to SABA alone, no statistically significant increase in the risk of serious side effects was observed for either ICS-formoterol or ICS-SABA.
The researchers said, “In a network meta-analysis of asthma patients, ICS combined with formoterol and ICS combined with SABA were each associated with reduced asthma exacerbations and improved asthma control,” and “both were associated with a lower risk of severe asthma exacerbations compared to SABA alone.” “He concluded.
