Ninety-two women in preterm labor were randomly assigned to either terbutaline or ethanol. In women with intact membranes, terbutaline was significantly more effective than ethanol in preventing progressive cervical dilation during the first 36 hours of treatment while betamethasone was given to the mother. Additionally, pregnancy was maintained significantly longer in women with intact membranes who were treated with terbutaline (15 +/- 4 days) rather than with ethanol (10 +/- 3 days). However, only 18% of women in each treatment group maintained their pregnancy beyond 36 weeks' gestation. In women with ruptured membranes and cervical dilation less than 4 cm, terbutaline was significantly better than ethanol in maintaining pregnancy for a minimum of 36 hours. Serious maternal side effects were not observed with terbutaline or ethanol, although a majority of women also received betamethasone. Neither drug caused serious adverse neonatal effects.

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http://dx.doi.org/10.1016/s0002-9378(16)32334-1DOI Listing

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Efficacy and Safety of As-Needed Budesonide-Formoterol in Adolescents with Mild Asthma.

J Allergy Clin Immunol Pract

August 2021

Division of Pulmonology, Department of Medicine, University of Cape Town, Cape Town, South Africa.

Background: Medication adherence is challenging for adolescents. In mild asthma, as-needed budesonide-formoterol (BUD-FORM) reduces severe exacerbations compared with as-needed short-acting beta-agonists, similar to the reduction with maintenance budesonide.

Objective: This post hoc pooled analysis of Symbicort Given as-needed in Mild Asthma (SYGMA) 1 and 2 assessed the efficacy and safety of as-needed BUD-FORM in adolescents.

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Introduction: Budesonide-formoterol taken as needed is an emerging treatment for mild asthma.

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Methods: SYGMA 1 and 2 were 52-week, double-blind, parallel-group studies in patients aged ≥ 12 years with physician-assessed mild asthma.

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Methods: Participants were randomised 1:1 to as-needed budesonide-formoterol (200/6 μg Turbuhaler, one actuation) or maintenance budesonide (200 μg Turbuhaler, one actuation twice a day) with as-needed terbutaline (250 μg, two actuations) for 52 weeks.

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Symptom-driven low-dose inhaled corticosteroid-formoterol is safe and effective in mild asthma and has been recommended as one of the preferred treatment regimens at steps 1 and 2 in the 2019 update of the Global Initiative for Asthma. However, there are no data on patient preferences for this regimen.A subgroup of participants in the PRACTICAL study (ACTRN12616000377437), a randomised controlled trial comparing symptom-driven budesonide-formoterol with maintenance budesonide plus as-needed terbutaline completed a survey on treatment preferences, satisfaction, beliefs and experience at their final study visit.

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