Possibilities of achieving of bronchial asthma control against the background of baseline therapy with beclometasone/formoterol extrafine fixed combination: an open observational prospective study

Background. The effectiveness of beclomethasone dipropionate/formoterol fumarate (BDP/FF) extrafine fixed combination is attributable to the anti-inflammatory effect on the small airways. The effect of the drug on the level of control of bronchial asthma (BA) in patients with cold and/or osmotic airway hyperresponsiveness has not been established. Objective. Evaluation of the possibility of achieving disease control against the background of therapy with BDP/FF extrafine fixed combination in patients with uncontrolled BA with cold and osmotic airway hyperresponsiveness. Methods. In 23 patients with uncontrolled BA and cold and/or osmotic airway hyperresponsiveness, asthma symptoms were assessed on a 5-point scale (Asthma Control Test - ACT); lung function (FEV1, MEF25-75) was evaluated before and after inhalation of a short-acting beta-agonist (SABA); inflammatory cells in sputum were examined initially and after 12-week use of BDP/FF extrafine fixed combination (100/6.0 pg) twice a day. Results. 7 days before treatment, 87% of patients had daily asthma attacks, 96% took additional SABA, mean ACT score was 13.8±0.79 points, FEV1 - 90.5±2.6%, MEF25-75 - 61.5±4.7%. After 6 weeks of treatment, ACT score >20 points were achieved by 74% of patients (mean 19.6±1.1 points; p=0.0008), FEV1 was 96.3±3.0%, and MEF25-75 - 68.6±4.7%. After 12 weeks, only 42% of patients had rare asthma attacks (x2=30.1; p<0.001), 52% continued to take SABA 1-2 times a week (x2=8.76; p<0.01). Good control was recorded in 90% of patients, and mean ACT score was 22.5±0.53 points (p<000001), FEV1 increased to 100.4±2.8% (p=0.013), MEF25-75 - to 76,7±4.4% (p=0.007). The reaction of the bronchi (AFEV1,%) to the administration of SABA decreased from 17.7±3.5 to 8.7±1.9% (p=0.001), the number of eosinophils in sputum - from 12.7±2.9 to 3, 2±0.9% (p=0.012). Conclusion. The treatment of patients with BDP/FF extrafine fixed combination for 12 weeks made it possible to achieve a controlled course of the disease without increasing the glucocorticoid dose, improve the respiratory function in patients with uncontrolled asthma and cold and/or osmotic airway hyperresponsiveness, and reduce sputum eosinophilia.

bronchial asthma, cold and osmotic airway hyperresponsiveness, beclamethasone dipropionate/formoterol fumarate extrafine fixed combination, asthma control