Comparison of the lung function change in patients with COPD and bronchial asthma before and after treatment with budesonide/formoterol

Objective: This study investigated the rapid onset of bronchodilation effect and compared lung function changes following budesonide/formoterol (Symbicort Turbuhaler (R)) inhalation in Chinese patients with moderate-severe chronic obstructive pulmonary disease (COPD) and bronchial asthma. Methods: In this open-label, parallel-group clinical study, patients eligible for study were divided into COPD group (n=62, mean age 68.16 +/- 8.75 years) and asthma group (n=30, mean age 45.80 +/- 12.35 years). Lung function tests (include FEV1, FVC, FEV1/FVC, and IC) were performed at baseline (t=0 min time point, value before inhalation of budesonide/formoterol), and then eligible patients received two inhalations of budesonide/formoterol (160/4.5 mu g). Lung function tests were reassessed at t=3, 10 and 30 min time point. The primary end-point was lung function change 3 min after drug inhalation, and the secondary end-points were comparison of the gas flow rate (Delta FEV1) and volume responses (Delta FVC, Delta IC) between COPD and asthma patients after inhalation of budesonide/formoterol. Results: Compared with the baseline, all patients significantly improved their lung function (included FEV1, FVC, FEV1/PVC, and IC) at 3 min (P<0.05). Greater bronchodilation efficacy was found in the asthma group compared with the COPD group (P<0.05). In the asthmatic patients, the curves of FEV1, FVC, FEV1/FVC, IC, showed improvement with an ascending trend at all time points from 3 to 30 min. Whereas in the COPD patients, only the curves of FEV1, PVC, IC showed similar pattern. We found that Delta FVC was significantly higher than Delta FEV1 in both groups (P<0.05), but no significant difference between Delta IC and Delta FEV1 (P>0.05). Compared with COPD group, asthma group had higher level of Delta FEV1 and Delta IC (P<0.05), but no significant difference for Delta FVC can be found. Conclusions: Budesonide/formoterol has a fast onset of bronchodilation effect in patients with moderate-severe COPD and asthma. Greater efficacy was found in the asthma group compared with the COPD group:The gas flow rate and volume responses in patients with COPD differ from those with asthma after inhalation of Budesonide/formoterol.