The rationale behind using budesonide and formoterol in a single inhaler is based on the landmark Pauwels et al study published in the New England Journal of Medicine. This study shows that when budesonide and formoterol are used together, the rate of severe asthma attacks in patients with moderate to severe asthma is reduced by between 26 and 63 percent, and mild attacks are reduced by up to 62 percent  [1].

The Pauwels'study also shows that adding formoterol to budesonide also improves control of asthma in terms of patients' lung function and night-time symptoms. Such benefits have the additional effect of providing a significant and sustained improvement in patients' quality of life  [2] .

With the first licence approval now granted in Sweden and further approvals expected throughout Europe later this year, AstraZeneca Vice-President and Head of Respiratory and Inflammation Research and Development (R&D), Dr Colin Reddrop, explained, "Asthma is a variable disease and Symbicort is the first and only asthma medication that allows the prescriber to tailor maintenance treatment according to the patient's symptoms using the same single inhaler. Symbicort could well become the standard therapy for the majority of asthma patients worldwide."

One of the unique benefits Symbicort provides for patients -- and which is highly valued by physicians as well -- is that dosing may be adjusted with the same single inhaler, as prescribed by the physician. Patients starting out on Symbicort are likely to be prescribed two inhalations twice daily. When good asthma control is achieved, the patient can then be maintained on a lower dose using the same inhaler with the option of once daily dosing. If asthma deteriorates, the prescriber can return the dose to the original two inhalations twice daily using the same single inhaler. No other currently available asthma therapy provides this degree of convenience for patients and physicians.

"Having budesonide and formoterol in the same inhaler to simultaneously treat underlying inflammation and bronchoconstriction, Symbicort Turbuhaler allows doctors to quickly and effectively gain and maintain control of their patient's condition, which will be key in terms of their long-term prognosis," Dr Reddrop added. Formoterol, one of the components of Symbicort, is the only long-acting beta-agonist with an onset of effect as rapid as that of short-acting beta agonists and with a safety profile at least as good.  [3],  [4]

"By providing doctors with a simple, patient-friendly treatment option in Symbicort Turbuhaler, and one which outdates traditional, multi-inhaler treatment regimens, we believe that we can aid patient adherence and thereby reduce the widespread problem of under-treatment in asthma,^*" Dr Reddrop concluded.

Symbicort Turbuhaler is expected to be available on prescription in Sweden from September 2000.

AstraZeneca is a major international healthcare business engaged in the research, development, manufacture and marketing of ethical (prescription) pharmaceuticals and the supply of healthcare services. It is one of the top five pharmaceutical companies in the world with healthcare sales of over $15 billion and leading positions in sales of gastrointestinal, oncology, anaesthesia including pain management, cardiovascular, central nervous system (CNS) and respiratory products.