Maintenance plus reliever budesonide/formoterol compared with a higher maintenance dose of budesonide/formoterol plus formoterol as reliever in asthma:an efficacy and cost-effectiveness study

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Abstract
Objective: To evaluate efficacy and costeffectiveness of budesonide/formoterol (Symbicort) maintenance (one dose once or twice daily) plus additional doses as needed (Symbicort Maintenance And Reliever Therapy, SMART) compared with a higher fixed dose of budesonide/ formoterol with formoterol as needed in patients with persistent asthma. * Symbicort is a registered trade name of the AstraZeneca group of companiesStudy design and methods: 6‐month, open, randomised study of 465 patients either not well controlled on an inhaled corticosteroid (ICS), or well controlled on a combination of ICS and a long-acting β2‐agonist (LABA). Treatments: budesonide/formoterol 160/4.5 µg, one inhalation, once or twice daily maintenance plus additional doses as-needed (1 × SMART or 2 × SMART), or budesonide/formoterol 160/4.5 µg two inhalations twice daily plus formoterol 4.5 µg as needed (2 × 2 FIX + F). Children 6–11 years old used an 80/4.5 µg dose strength. Primary variables of efficacy were the changes in the As...