Adjustable maintenance dosing with XXXX / @entity6410 reduces @entity565 exacerbations compared with traditional fixed dosing: a five-month multicentre Canadian study.

@entity1 @entity565 @entity4184 @entity6410 @entity28304
BACKGROUND: Adjustable maintenance dosing with @entity4184 / @entity6410 in a single inhaler ( @entity28304 , AstraZeneca, Lund, Sweden) may provide a convenient means of maintaining @entity565 control with the minimum effective medication level. OBJECTIVES: To compare adjustable and fixed maintenance dosing regimens of @entity4184 / @entity6410 in @entity565 . METHODS: This was an open-label, randomized, parallel-group, multicentre, Canadian study of @entity565 @entity1 (aged 12 years or older, postbronchodilator forced expiratory volume in 1 s 70% or greater of predicted normal). Following a one-month run-in on @entity4184 / @entity6410 (100/6 mg or 200/6 mg metered doses, two inhalations twice daily), 995 @entity1 were randomly assigned either to continue on this fixed dosing regimen or to receive @entity4184 / @entity6410 adjustable dosing (step down to one inhalation twice daily if symptoms were controlled or temporarily step up to four inhalations twice daily for seven or 14 days if @entity565 worsened). The primary efficacy variable was the occurrence of exacerbations (requiring oral or inhaled corticosteroids, emergency department treatment, serious adverse events or added maintenance therapy because of @entity565 ). RESULTS: With adjustable dosing, significantly fewer @entity1 experienced exacerbations compared with fixed dosing (4.0% versus 8.9%, P=0.002; number needed to treat=21 [95% CI 13 to 59]). @entity1 required 36% fewer overall doses of @entity4184 / @entity6410 (2.5 versus 3.9 inhalations/day, P<0.001), and total costs per @entity1 were lower (difference over five months -141 Canadian dollars [95% CI -162 Canadian dollars to -116 Canadian dollars]). Asthma symptom severity (modified National Heart, Lung, and Blood Institute stage) was maintained or improved in 97% or greater of @entity1 in both groups (pre-run-in to end of treatment). Both treatments were well tolerated. CONCLUSIONS: @entity4184 / @entity6410 adjustable maintenance dosing provided more effective @entity565 control than fixed dosing, with a lower overall drug dose and reduced total cost.
