FACET (Formoterol and Corticosteroids Establishing Therapy) Study: A Landmark Study in Asthma Therapy

calendar
2 Jan, 13

Aim

  • To evaluate the effects of adding inhaled formoterol to both lower and higher doses of the inhaled glucocorticoid budesonide.

Hypothesis - By addition of LABA to ICS, the risk of exacerbations will increase.

Study Methods

  • Double-blind, randomized, placebo-controlled, parallel-group, multicentre trial
  • 852 asthma patients aged 18 to 70 years using inhaled corticosteroid with FEV1 >= 50% of predicted, >= 15% reversibility
  • 4 week run-in period during which patients received 800 mcg budesonide b.i.d.

Study Design

Primary Efficacy Variable

  • The primary efficacy variables studied were the rates of severe and mild exacerbations of asthma per patient per year.

  • Other variables like
    • PEF,
    • symptoms (score),
    • awakening due to asthma
    • use of oral glucocorticoids were also recorded.

Results

Rate of severe exacerbation

Rate was reduced by 26% in low dose BUD and FORM group and by 63% in high dose BUD and FORM

Rate of mild exacerbation

Rate of mild exacerbations reduced by 40% when FORM was added to lower dose of BUD

  • Symptoms - Significant improvement in both day and night time symptom scores in combination groups.
  • Lung Function - Higher dose BUD/FORM > lower dose BUD/FORM > high dose BUD > low dose BUD
  • All the treatment strategies were well tolerated.

Conclusion

  • There was no evidence of deterioration in the control of asthma over the course of one year when formoterol was added to budesonide therapy.
  • BUD/FORM decreases the incidence and rates of mild and severe exacerbations.
  • BUD/FORM also improved asthma symptom scores and lung function and reduced the need for rescue medication.

N Engl J Med 1997; 337: 1405-11