Abstract
The objective of this study was to determine outcomes of salmeterol/fluticasone (SFC) and budesonide
(BUD) for asthma control in real-life situation in community hospitals. A retrospective cohort study was
conducted to collect data from Easy Asthma Clinic database year 2007-2011 in seven community hospitals.
Uncontrolled asthmatic patients with medium-dose BUD who were prescribed SFC or BUD were
divided into three groups: 1) medium-dose BUD (n=170), 2) high-dose BUD (n=88) and 3) SFC 50/250 μg twice daily (n=128). The patients were followed for a year to measure the study outcomes. Comparative
treatment outcomes were analyzed using multivariable analyses to control potential confounders. The
results revealed that the proportions of well controlled patients were 7.6%, 20.0% and 28.9% in mediumdose
BUD, high-dose BUD and SFC group, respectively (p<0.001). The proportions of patients with emergency
room visit were 45.3%, 30.7% and 28.1% in medium-dose BUD, high-dose BUD and SFC group,
respectively (p=0.009) whereas the proportions of patients with hospitalization were 20.6%, 17.5% and
19.5% in medium-dose BUD, high-dose BUD and SFC group, respectively (p=0.902). Side effects of the
medications were 5.9%, 10.2% and 0% in medium-dose BUD, high-dose BUD and SFC group, respectively
(p=0.002). Comparing with medium-dose BUD group, SFC group achieved well controlled more than
9.16 times (OR=9.16, 95%CI: 3.88, 21.64) and decreased emergency room visits by 47% (HR=0.53, 95%CI:
0.35, 0.79). Differential outcome between high-dose BUD and medium-dose BUD was not found. In conclusion,
salmeterol/fluticasone provides better outcomes and fewer adverse effects than budesonide.
