Symbicort Maintenance and Reliever Therapy

COMPASS:* A 6-month, double-blind, double-dummy, randomised parallel group study compared the safety and efficacy of Symbicort for maintenance and relief with salmeterol/fluticasone and a fixed maintenance dose of Symbicort, both with terbutaline for relief.20
Primary endpoint: Time to first severe exacerbation (defined as deterioration of asthma resulting in hospitalisation, emergency room treatment, or the need for oral steroids for ≥3 days, as judged by the investigator).20

For further details on the COMPASS trial, view the COMPASS Clinical Summary.

Outcomes with Symbicort Maintenance and Reliever Therapy vs medium dose salmeterol/fluticasone + SABA

  • Symbicort Maintenance and Reliever Therapy significantly prolonged the time to first exacerbation (primary endpoint) vs fixed dose salmeterol/fluticasone and Symbicort (both with SABA as needed) (p=0.003 and p=0.023).20
  • As well as meeting its primary endpoint in this study, Symbicort Maintenance and Reliever Therapy significantly reduced the number of severe exacerbations over 6 months.*,20
Symbicort Maintenance and Reliever Therapy
Symbicort Maintenance and Reliever Therapy

bid: twice per day; BUD/FORM: budesonide/formoterol; ER: emergency room; FEV1: forced expiratory volume in 1 second; ICS: inhaled corticosteroid; LABA: long-acting beta-agonist; PEF: peak expiratory flow; SABA: short-acting β2-agonist; SAL/FLU: salmeterol/fluticasone.

*3,335 patients aged 12 years and over with persisting asthma on medium dose ICS or ICS/LABA (baseline mean FEV1 73% predicted, baseline mean inhaled corticosteroid dose 745 µg/day). Secondary endpoints: The total numbers of severe exacerbations; inhalations of as-needed medication; change in morning and evening PEF; FEV1, asthma symptom score; nights with awakenings caused by asthma; symptom-free days; as needed-free days; asthma-control days and the number of mild exacerbations.20

Severe exacerbations were defined as deterioration in asthma resulting in hospitalisation or emergency room (ER) treatment, or the need for oral steroids for ±3 days (as judged by the investigator).

Can you think of patients like Sam who could benefit from Symbicort Maintenance and Reliever Therapy?

Based on COMPASS, prescribing Symbicort Maintenance and Reliever Therapy may:

 

1 Help reduce Sam’s risk of an asthma attack

In COMPASS, Symbicort*,** reduced the incidence of severe exacerbations by 39% vs salmeterol / fluticasone + SABA (12 vs 19; HR 0.61, 95% CI: 0.49, 0.76, p<0.001)20

CI: confidence interval; HR: hazard ratio; SABA: short acting beta-agonist.
Severe exacerbations defined as a deterioration in asthma resulting in hospitalization or emergency/room treatment, or the need for oral steroids for ≥3 days (as judged by the investigator).

 

2 Help improve Sam's overall symptom control

In COMPASS, Symbicort*,** demonstrated 7x more asthma control days vs baseline (41.3% vs 5.8% days respectively. This outcome was similar in all study arms.20
The formoterol component of Symbicort* provides rapid symptom control and is as effective as a SABA (salbutamol)21

 

3 Help lower Sam’s inhaled steroid load

In COMPASS, Symbicort*,** delivered similar symptom control and achieved fewer severe exacerbations20 at a 25% lower mean daily inhaled steroid load than salmeterol/fluticasone + SABA (755 µg vs 1000 µg BDP equivalents respectively)20

BDP: beclomethasone dipropionate.
* Maintenance and reliever therapy.
** Symbicort is not intended for regular prophylactic use (e.g., before exercise): a separate bronchodilator should be considered. Symbicort 400/12 μg is not licensed for Symbicort Maintenance and Reliever Therapy dosing.

Symbicort: One inhaler; every morning, every evening and as needed.1,2
Consider Symbicort for your patients who are on maintenance therapy but still rely on their blue inhaler for symptom relief.

SMART Thinking: Severe exacerbations and hypothetical treatment outcomes22

Study Design: Profile of 425 severe exacerbations* in 242 patients. Hypothetical outcome refers to the hypothesised reduction in night-time symptoms and requirement for SABA rescue use when budesonide and formoterol are utilised together during the “window of opportunity”.

Hypothetical outcome: Using Symbicort Maintenance and Reliever Therapy** delivers the additional ICS needed to treat the underlying inflammation when required and may help to reduce the severity of an asthma attack which has been shown in subsequent studies.20,23

SMART Thinking: Severe exacerbations and hypothetical treatment outcomes
SMART Thinking: Severe exacerbations and hypothetical treatment outcomes