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This website is intended for UK Healthcare Professionals only. Other UK residents please visit astrazeneca.co.uk
Symbicort® Reliever Therapy (Turbohaler® 200/6) can be prescribed as a reliever therapy for adults and adolescents 12 years and older with mild asthma, giving them relief of their asthma symptoms while at the same time delivering a small amount of steroid to treat their inflammation.1
For more information on other Symbicort® indications click here.
Based on Sam’s symptoms, you suspect she may have mild asthma
*Please note that Sam is a fictional patient and case study
Diagnosis: mild asthma
Prescribed treatment: ICS (brown inhaler) +
SABA (blue inhaler) as needed
*Please note that Tony is a fictional patient and case study
Over-relying† on SABA inhalers is not only a potential issue for your patients.
The use of SABA inhalers also contributes to the UK’s total inhaler carbon footprint, of which 70% of this footprint comes from SABAs with 83% of SABAs prescribed are to patients using more than three inhalers a year.8,9
†Over-reliance is defined as ≥3 inhalers/year (pMDI and DPI). This figure is extracted from the SABINA UK study9 and extrapolated to the UK adult asthma population.
^Defined as either asthma worsening that necessitated a short course of OCS (≤300mg; not during an annual asthma review or on days treated for other steroid responsive diseases - GP managed exacerbation), an Accident and Emergency (A&E) department visit for asthma, a hospital admission or death secondary to asthma.
Patients want fast relief from their symptoms and tend to continue with medication regimes they already know when symptoms occur – including increasing their use of SABA.10
Symbicort® Reliever Therapy (Turbohaler® 200/6) is SABA-free combining both a preventer and reliever in one inhaler.1 It’s taken as needed to give patients the symptom relief they seek while reducing underlying inflammation.1
If your patients' asthma treatment needs to be stepped up or down, Symbicort® Reliever Therapy (Turbohaler® 200/6) can be titrated as a continuum of inhaled therapy in line with their HCP consultation and agreed personal asthma action plan.1
When Symbicort® Reliever Therapy (Turbohaler® 200/6) is taken as a reliever, patients should take 1 inhalation as needed in response to symptoms. If symptoms persist after a few minutes, an additional inhalation should be taken. Not more than 6 inhalations should be taken on any single occasion.1
If a patient finds the treatment less effective or experiences progressive deterioration of symptoms despite taking Symbicort® as needed, the patient should seek medical attention as soon as possible (see section 4.4 of the Symbicort® Turbohaler® 200/6 SmPC for further information).1
A total daily dose of more than 8 inhalations is not normally needed; however, a total daily dose of up to 12 inhalations could be used for a limited period. Patients using more than 8 inhalations daily should be reassessed for alternative explanations of persisting symptoms. Patients should be assessed at regular intervals according to local practice to determine whether their as-needed treatment with Symbicort® remains optimal or whether regular scheduled treatment with inhaled corticosteroid-containing maintenance medication should be initiated.1
For more information on Symbicort® Turbohaler® 200/6 please see SmPC
For full information on the efficacy data supporting Symbicort® Reliever Therapy (Turbohaler® 200/6) please consult the SmPC.
SYGMA 1 O’Byrne PM, FitzGerald JM, Bateman ED, et al. Inhaled combined budesonide–formoterol as-needed in mild asthma. N Engl J Med 2018;378:1865–1876
SYGMA 1 was a 52-week, Phase III, multicentre, randomised, double-blind, parallel-group study that compared as-needed budesonide/formoterol with as-needed terbutaline and maintenance budesonide plus as-needed terbutaline in 3836 patients with mild asthma.
Design: 3836 patients aged 12 years and older with a clinical diagnosis of asthma for 6 months or more and with confirmation of bronchodilator reversibility were enrolled in the study.
Patients were randomized to 1 of the following treatments:
Objective: To investigate the long-term efficacy and safety of as-needed budesonide/formoterol dry powder inhaler (DPI) compared with as-needed terbutaline and maintenance budesonide.
Results:
Primary endpoint was to investigate the superiority of as-needed Symbicort® Reliever Therapy versus as-needed terbutaline alone in terms of asthma symptom control, measured as weeks with well-controlled asthma.
Secondary endpoints included comparing as-needed Symbicort® Reliever Therapy versus as-needed terbutaline alone and versus budesonide maintenance
+ terbutaline in rates and time to the first severe exacerbation.
^measure: electronically captured well controlled asthma weeks (eWCAW)
*Severe exacerbation was defined as worsening asthma leading to systemic glucocorticoid treatment for ≥3 days, hospitalisation or emergency room visit leading to systemic glucocorticoid treatment; moderate–severe exacerbation was defined as including worsening asthma requiring addition of twice-daily inhaled budesonide 200 μg to avoid progression to a severe exacerbation11
NOVEL START Beasley R, Holliday M, Reddel HK, et al. Controlled trial of budesonide–formoterol as-needed for mild asthma. N Engl J Med 2019;380:2020–2030
Novel START was a 52-week, multicentre, randomised, open-label study that compared as needed budesonide/formoterol dry powder inhaler (DPI) as an anti-inflammatory reliever with as-needed salbutamol* and with maintenance budesonide plus as-needed salbutamol* in patients with mild asthma.
Design: 675 patients aged 18 years and older with a self-reported diagnosis of asthma (from a physician) were enrolled in the study. Patients were included if they had used SABA as their sole asthma therapy in the previous 3 months, on at least 2 occasions in the previous 4 weeks, but no more than 2 occasions per day, on average, in the previous 4 weeks.
The patients were randomised to one of the following treatments:
Objective: To investigate budesonide/formoterol reliever therapy used on an as-needed basis among adults with mild asthma who had been treated previously with only as-needed short-acting β2-agonist (SABA).
Results:
Primary endpoint was the annualized rate of asthma exacerbations per patient
Secondary endpoint was the number of severe exacerbations
^An exacerbation was defined as worsening asthma that resulted in one or more of the following: an urgent medical care consultation (e.g., a primary care visit, an emergency department [ED] visit, or hospital admission); a prescription of systemic glucocorticoids for any duration; or an episode of high beta2-agonist use, which was defined as more than 16 actuations of salbutamol** or more than 8 actuations of Symbicort® over the course of 24 hours12
*Severe exacerbation was defined as worsening asthma leading to systemic glucocorticoid treatment for ≥3 days, hospitalisation or emergency room visit leading to systemic glucocorticoid treatment.
**In the study, salbutamol was referred to as ‘albuterol’, which is its US non-proprietary name.
CI, confidence interval; BID, twice daily; OR, odds ratio; DPI, dry-powder inhaler; eWCAW, electronically captured well controlled asthma weeks; HCP, healthcare professional; ICS, inhaled corticosteroids; LABA, long-acting β2 adrenoceptor agonists; OCS, oral corticosteroids; pMDI, pressurised metered-dose inhaler; RR, relative rate; SABA, short-acting β2 antagonist; ARR, absolute risk reduction; ARI, absolute risk increase; SmPC, Summary of Product Characteristics.
GB-56713 | DOP: December 2024
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to AstraZeneca by visiting https://contactazmedical.astrazeneca.com/ or by calling 0800 783 0033.
This website was created for UK HCPs and has been designed to provide information to educate, empower and enable them in the great work they are doing for patients across a range of therapy areas. This website is intended for doctors, nurses, and pharmacists in the UK. Other UK residents please visit astrazeneca.co.uk.
