Latest Guidance Issued by BTS/SIGN Supports use...

LONDON, July 2 /PRNewswire/ --     Updated guidelines issued this week by the 
British Thoracic Society (BTS)
and Scottish Intercollegiate Guidelines Network (SIGN) include the use of
budesonide/formoterol in a single inhaler as rescue medication, in addition
to its regular use as controller therapy, in selected adult patients poorly
controlled at step 2 or selected adult patients with poorly controlled asthma
at step 3(1).



    The BTS/SIGN guidelines recognise the evidence supporting the efficacy of
Symbicort(TM) (budesonide/formoterol) Maintenance And Reliever Therapy
(Symbicort SMART(TM)) as rescue medication instead of a short-acting beta2 
agonist (SABA) in selected adult patients poorly controlled at step 2 (above 
BDP 400mcg) or selected adult patients with poorly controlled asthma at step 
3(1). Budesonide/formoterol is the only combination inhaler that has been
recommended for this purpose within the revised guidelines as this management
technique has not been investigated with other combination inhalers(1).



    Commenting on the launch of the new guidelines, Doctor Kevin
Gruffydd-Jones from the Universities of Bath and Aberdeen said:



    "The recent update in the BTS/SIGN pharmacology guidelines has reinforced
and confirmed the position of Symbicort SMART in asthma management. The
evidence has shown that in patients with persistent asthma, who are
ineffectively controlled [at both step 2 and step 3 of the guidelines]
Symbicort SMART used as both a maintenance and reliever therapy is an
effective and simple treatment regime. When used in this way it has been
shown to reduce exacerbations which may in turn result in reduced
hospitalisations and A&E visits."



    The Symbicort Summary of Product Characteristics recommends the use of
budesonide/formoterol for adults aged 18 years and older who are suitable for
combination therapy, especially those with inadequate asthma control and in
frequent need of reliever medication, as well as in patients who have had
asthma exacerbations requiring medical interventions(2).



    Symbicort SMART(R) was launched in the UK in June 2007. Patients
take a regular dose consisting of the inhaled corticosteroid (ICS),
budesonide and the LABA, formoterol, and additional inhalations, if required,
to provide symptom relief and simultaneously improve control. As with other
combination asthma therapies, Symbicort SMART is not licensed for regular
prophylactic use before exercise(2).



    Respiratory nurse consultant, Jane Scullion from Glenfield Hospital
comments:



    "These updated guidelines are very important for those patients with
asthma which is currently not well controlled. We have a key role to play in
helping educate patients on the role of budesonide/formoterol in controlling
symptoms and in helping them adjust to use of a combination inhaler in this
way. Patients adhere to therapies that are simple and convenient to use and
use of budesonide/formoterol in a single inhaler as rescue medication, in
addition to its regular use as controller therapy can offer this convenience
to patients"



Notes to Editors

    1. In 2006, about 1,200 people died from asthma - an average of three
people per day or one person every seven hours(3)



    2. With Symbicort SMART, patients receive a maintenance dose of Symbicort
in line with normal practice to establish asthma control and take additional
inhalations 'as required' of Symbicort if symptoms occur, to provide both
rapid symptom relief and increased asthma control



    3. Symbicort SMART has been shown to reduce asthma exacerbations and
maintain similar daily asthma control at a lower overall drug load compared
with higher traditional fixed dosing ICS/LABA combination plus SABA(4)



    4. Patients suitable for the Symbicort SMART treatment approach would no
longer require a separate bronchodilator for the treatment of asthma symptoms



5. The updated BTS/SIGN guidelines include Symbicort SMART as follows:

    "In selected adult patients at step 3 who are poorly controlled or in
selected adult patients at step 2 (above BDP 400 mcg/day who are poorly
controlled), the use of budesonide/formoterol in a single inhaler as rescue
medication instead of a short-acting β2 agonist, in addition to its regular
use as controller therapy has been shown to be an effective treatment regime.
When this management option is introduced the total regular dose of daily
inhaled corticosteroids should not be decreased. The regular maintenance dose
of inhaled steroids may be budesonide 200 mcg twice daily or budesonide 400
mcg twice daily. Patients taking rescue budesonide/ formoterol once a day or
more should have their treatment reviewed. Careful education of patients
about the specific issues around this management strategy is required"



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References

    (1) British Thoracic Society (BTS) and Scottish Intercollegiate
Guidelines Network (SIGN) Guidelines. British Guideline on the Management
of Asthma, 2009. http://www.sign.ac.uk/pdf/sign101.pdf (Full Guidance
Document)


(2) Summary of Product Characteristics (SmPC) 2008

(3) Asthma UK. For journalists: key facts & statistics

    (4) Kuna P et al. Effect of budesonide/formoterol maintenance and
reliever therapy on asthma exacerbations Int J Clin Pract 2007;61:
725-736




For further information, please contact:

    Suzie Collett, Respiratory Communications Manager, AstraZeneca: 
[phone]



    Maria Parnham, Head of Medical Education and PR, Brand(x) Communications:
[phone]