Formoterol (OXIS®) Turbuhaler® as a rescue therapy compared with salbutamol pMDI plus spacer in patients with acute severe asthma

Formoterol has a similar onset of effect to salbutamol but a prolonged duration of action. However, the relative efficacy of the two drugs in acute severe asthma is not known. This double-blind, double-dummy study compared the safety and efficacy of the maximum recommended daily dose of formoterol and a predicted equivalent dose of salbutamol in 88 patients presenting to the emergency department with acute severe asthma. Patients were randomized to formoterol 54 mug via Turbuhaler(R) or salbutamol 2400 mug via pressurized metered dose inhaler (pMDI) plus spacer in three equal doses over 1 h. Following the full dose, mean FEV1 at 75 min increased by 37% for formoterol and 28% for salbutamol (P = 0.18). The maximum increase in FEV1 over 4 h was significantly greater with formoterot compared with salbutamol (51% vs. 36%, respectively P<0.05) and formoterot was as effective as salbutamol at improving symptoms and wellbeing. Both treatments were well tolerated. Formoterol caused a greater decrease in serum potassium (difference 0.2 mmol/l). In severe acute asthma, bronchodilator therapy with high-dose (54 μg) formoterot Turbuhaler provided equally rapid improvements in lung function of greater magnitude over 4 h than high-dose (2400 μg) salbutamol pMDI plus spacer. (C) 2003 Elsevier Ltd. All rights reserved.