AstraZeneca Launches New Advance In Asthma Treatment - Symbicort Maintenance And Reliever Therapy (Symbicort SMART)

Main Category: Respiratory / Asthma
Article Date: 04 Jun 2007 - 1:00 PDT

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AstraZeneca today announced the UK launch of Symbicort (budesonide/formoterol) Maintenance And Reliever Therapy (Symbicort SMART), the first treatment approach to allow asthma patients uncontrolled on inhaled corticosteroid (ICS) to receive both maintenance and reliever therapy in a single inhaler.

This latest development has the potential to make it more convenient for patients to manage their asthma by providing medicines for control and relief in one inhaler, meaning that they no longer require a separate reliever inhaler to target their symptoms.1

A significant advance in asthma management, Symbicort SMART offers a simple, effective approach to treatment. Patients receive a maintenance dose of their inhaler, and take additional inhalations 'as needed' if symptoms occur to provide rapid symptom relief and increased asthma control. The Symbicort SMART treatment approach is possible because Symbicort combines the two components budesonide, an Inhaled Corticosteroid (ICS) providing anti-inflammatory effect, and formoterol, a rapid and long-acting bronchodilator (LABA) in one inhaler. Specifically the rapid onset of action is due to the formoterol component, which has demonstrated a faster speed of onset than salmeterol, the LABA component in Seretide.2

Despite efficacious therapies, 74% of patients over rely on their reliever. However, reliever therapy using a short acting beta agonist (SABA) does not address the underlying inflammation. Symbicort SMART targets this fundamental problem by treating the underlying inflammation with every inhalation.1 Symbicort SMART is licensed for use in 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.1 As with other combination asthma therapies, Symbicort SMART is not licensed for prophylactic use before exercise.1

"As well as compelling data, there are many appealing practical features of using this approach in the management of asthma", comments Glasgow based General Practitioner Dr John Haughney. "By reducing the symptoms and the number of attacks they experience, patients now have the means to achieve control of their asthma using only one inhaler. As a result, this advance has the potential to improve the lives of many asthma sufferers. Importantly, Symbicort SMART is easy for healthcare professionals to teach and for people with asthma to use."

Symbicort SMART has been used in a large clinical trial programme involving more than 14,000 patients. The recently published COMPASS study, the largest of its type in asthma, demonstrates that patients taking Symbicort SMART experienced a significant decrease in severe exacerbations compared to Seretide plus a separate reliever or fixed dose Symbicort plus a separate reliever.

The recent publication of a scientific review in the European Respiratory Journal by Professor Peter Barnes, Professor of Thoracic Medicine and Head of Respiratory Medicine at the National Heart and Lung Institute, Imperial College, London, also provides a scientific rationale for using Symbicort as both maintenance and reliever therapy and advocates that this may become the mainstay of future asthma treatment in appropriate patients.

The Global INitiative for Asthma (GINA) Scientific Committee has incorporated the Symbicort SMART concept into the updated version of their international treatment guidelines.6 The guidance states that a combination inhaler containing budesonide and formoterol used as both maintenance and rescue therapy can maintain a high level of asthma control, reducing exacerbations requiring oral steroids or hospitalisation.

Professor Peter Barnes, a member of the GINA Executive Committee said, "The results of published studies consistently show that Symbicort SMART, reduces the risk of patients developing severe exacerbations.4-6 This new treatment approach represents a significant advance in how we treat asthma, and consequently we have recognised Symbicort SMART within the new GINA guidance".

AstraZeneca is a major international healthcare business engaged in the research, development, manufacture and marketing of prescription pharmaceuticals and the supply of healthcare services. It is one of the world's leading pharmaceutical companies with healthcare sales of $26.47 billion and leading positions in sales of gastrointestinal, cardiovascular, neuroscience, respiratory, oncology and infection products. AstraZeneca is listed in the Dow Jones Sustainability Index (Global) as well as the FTSE4 Good Index.

-- Many asthma patients require maintenance treatment with an inhaled corticosteroid, which suppresses the underlying airway inflammation, as well as a bronchodilator, which relaxes the smooth muscle of the airways

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

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

-- As with other combination asthma therapies, Symbicort SMART is not licensed for prophylactic use e.g. before exercise.1

References

1) Symbicort Summary of Product Characteristics

2) Partridge MR, van der Molen T, Myrseth, S-E, Busse WE. Actions and attitudes of asthma patients on regular maintenance therapy: the INSPIRE study BMC Pulmonary Medicine 2006, 6:13 www.biomedcentral.com/bmcpulmmed

3) Kuna P, Peters MJ, Manra A et al. Effect of budesonide/formoterol maintenance and reliever therapy reduces on asthma exacerbations. Int J clin Prac 2007

4) Vogelmeier C, D'Urzo A, Pauwels R, Merino JM, Jaspal M, Boutet S, Naya I, Price D. Budesonide/formoterol maintenance and reliever therapy: an effective asthma treatment option? Eur Respir J 2005; 26(5): 819-828.

5) O'Byrne P, Bisgaard H, Godard P, Pistolesi M, Palmqvist M, Zhu Y, Ekström T, Bateman E. Budesonide/Formoterol Combination Therapy as Both Maintenance and Reliever Medication in Asthma. American Journal of Respiratory and Critical Care Medicine 2005; 171(2): 129-136.

6) Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention 2006. www.ginasthma.org

7) Tattersfield AE et al. Exacerbations of asthma: a descriptive study of 425 severe exacerbations. The FACET International Study Group. American Journal of Respiratory and Critical Care Medicine 1999; 160(2): 594-599

8) Kuna P, Peters MJ, Manra A et al. Effect of budesonide/formoterol maintenance and reliever therapy reduces on asthma exacerbations. Int J clin Prac 2007

9) Barnes PJ: Scientific rationale for using a single inhaler for asthma control Eur Respir J 2007; 29:587-595

10) Scicchitano R, Aalbers R, Ukena D, Manjra A, Fouquert L, Centanni S, Boulet L-P, Naya IP, Hultquist C. Efficacy and safety of budesonide/formoterol single inhaler therapy versus a higher dose of budesonide in moderate to severe asthma. Current Medical Research and Opinion 2004; 20(9): 1403-18.

11) Rabe K, Pizzichini E, Ställberg B, Romero S, Balanzat AM, Atienza T, Lier PA, Jorup C, Budesonide/Formoterol in a Single Inhaler for Maintenance and Relief in Mild-to-Moderate Asthma: A Randomized, Double-Blind Trial, Chest, Feb 2006; 129: 246 - 256.

12) Rabe K, Atienza T, Magyar P et al. Effect of budesonide in combination with formoterol for reliever therapy in asthma exacerbations: a randomised, controlled, double-blind study. Lancet 2006;368: 744-53

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