Is budesonide-formoterol (Symbicort) a good option for achieving asthma control?

From the Guidelines

Budesonide-formoterol (Symbicort) is a highly recommended option for achieving asthma control, particularly in individuals aged 12 years and older with moderate to severe persistent asthma, as it offers both anti-inflammatory and bronchodilating effects, leading to improved lung function and fewer exacerbations. This combination medication is typically used as a maintenance therapy, with common brands including Symbicort and Dulera. The usual dosage is 1-2 inhalations twice daily, but it can also be used as needed for symptom relief in some patients (known as SMART therapy - Single Maintenance and Reliever Therapy) 1.

Key Benefits of Budesonide-Formoterol

• Provides both quick symptom relief and long-term control, reducing the need for separate rescue inhalers
• Suitable for most adults and children over 6 years with persistent asthma
• Offers improved lung function and fewer exacerbations compared to other treatment options
• Can be used as both daily controller and reliever therapy in individuals aged 12 years and older with moderate to severe persistent asthma

Important Considerations

• The dosage should be tailored to the individual patient's needs under medical supervision
• Budesonide-formoterol is not recommended for use as monotherapy for long-term control of persistent asthma in patients who are not already on an inhaled corticosteroid 1
• The combination of budesonide and formoterol helps to control asthma symptoms more effectively than either component alone, leading to improved lung function and fewer exacerbations 1

Recent Guidelines and Recommendations

• The 2020 focused updates to the NIH asthma management guidelines recommend the use of ICS-formoterol in a single inhaler as both daily controller and reliever therapy for individuals aged 12 years and older with moderate to severe persistent asthma 1
• The expert panel conditionally recommends against adding LAMA to ICS, as opposed to adding LABA to ICS, in individuals aged 12 years and older with uncontrolled persistent asthma 1

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Efficacy of Budesonide-Formoterol in Achieving Asthma Control

• Budesonide-formoterol (Symbicort) has been shown to be effective in achieving asthma control in patients with persistent asthma 2, 3, 4, 5, 6.
• Studies have demonstrated that budesonide-formoterol improves lung function, reduces symptoms, and decreases the risk of asthma exacerbations compared to treatment with an inhaled corticosteroid alone or a long-acting beta2-adrenergic agonist alone 3, 4, 5.
• The combination of budesonide and formoterol in a single inhaler has been shown to provide greater improvements in asthma control than increasing the maintenance dose of inhaled corticosteroid alone 5.

Patient-Reported Outcomes and Quality of Life

• Budesonide-formoterol has been shown to improve patient-reported outcomes, including health-related quality of life, patient satisfaction, and sleep quality 2, 4.
• The rapid onset of effect of budesonide-formoterol, which can be felt by patients within 15 minutes, may have benefits for treatment adherence 2.

Safety and Tolerability

• Budesonide-formoterol has been shown to be well tolerated, with an adverse event profile similar to that of budesonide alone or other inhaled corticosteroid/long-acting beta2-adrenergic agonist combinations 3, 4, 6.
• The safety profile of budesonide-formoterol has been evaluated in several studies, including a 52-week tolerability study, and has been found to be similar to that of budesonide alone 4.