{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:34:46Z","timestamp":1791812086327,"version":"4.3.4"},"reference-count":31,"publisher":"BMJ","issue":"8","funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["IRO [18\/002]"],"award-info":[{"award-number":["IRO [18\/002]"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Thorax"],"accepted":{"date-parts":[[2022,7,1]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare bronchodilator response after to salbutamol and budesonide\/formoterol in adults with stable asthma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A double-blind, cross-over, single-centre, placebo-controlled, non-inferiority trial. Adults with stable asthma were randomised to different orders of two treatment regimens: two actuations of placebo via MDI and one actuation of budesonide\/formoterol 200\/6 \u00b5g via turbuhaler; and one actuation of placebo turbuhaler and two actuations of salbutamol 100 \u00b5g via MDI. The primary outcome measure was FEV<jats:sub>1<\/jats:sub>after 2 min. Secondary outcome measures included FEV<jats:sub>1<\/jats:sub>, mBorg Dyspnoea Scale score and visual analogue score for breathlessness over 30 min.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty-nine of 50 potential participants were randomised. One participant withdrew following the first intervention visit and another could not be randomised due to COVID-19 restrictions. The mean (SD) change from baseline FEV<jats:sub>1<\/jats:sub>2 min after treatment administration for budesonide\/formoterol and salbutamol was 0.08 (0.14) L, n=49, and 0.17 (0.18) L, n=48, respectively, mean (95% CI) paired difference of \u22120.097 L (\u22120.147 to \u22120.047), p=0.07, against a non-inferiority bound of \u22120.06 L. In the secondary analysis, FEV<jats:sub>1<\/jats:sub>over 30 min was lower for budesonide\/formoterol compared with salbutamol, difference (95% CI): \u22120.10 (\u22120.12 to \u22120.08) L, p&lt;0.001. There were no differences in Visual Analogue Scale score or mBorg Dyspnoea Scale score between treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results do not support the primary hypothesis of non-inferiority at the boundary of \u22120.06 L for the difference between budesonide\/formoterol 200\/6 \u00b5g compared with salbutamol 200 \u00b5g for FEV<jats:sub>1<\/jats:sub>at 2 min, and could be consistent with inferiority with a p value of 0.07. For the secondary analysis of FEV<jats:sub>1<\/jats:sub>measurements over time, the FEV<jats:sub>1<\/jats:sub>was higher with salbutamol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p>Australian and New Zealand Clinical Trials Registry (ACTRN 12619001387112).<\/jats:p><\/jats:sec>","DOI":"10.1136\/thorax-2022-219052","type":"journal-article","created":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T17:20:48Z","timestamp":1658164848000},"page":"745-751","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Single dose of budesonide\/formoterol turbuhaler compared to salbutamol pMDI for speed of bronchodilator onset in asthma: a randomised cross-over trial"],"prefix":"10.1136","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3188-991X","authenticated-orcid":false,"given":"Nethmi","family":"Kearns","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pepa","family":"Bruce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Black","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1254-8287","authenticated-orcid":false,"given":"Cil\u00e9in","family":"Kearns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Sparks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5327-3027","authenticated-orcid":false,"given":"Irene","family":"Braithwaite","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Weatherall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0337-406X","authenticated-orcid":false,"given":"Richard","family":"Beasley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,7,18]]},"reference":[{"key":"2024051320303207000_78.8.745.1","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00701-2020"},{"key":"2024051320303207000_78.8.745.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.2769"},{"key":"2024051320303207000_78.8.745.3","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00625-2020"},{"key":"2024051320303207000_78.8.745.4","doi-asserted-by":"crossref","DOI":"10.1016\/j.rmed.2021.106611","article-title":"Smart for the treatment of asthma: a network meta-analysis of real-world evidence","volume":"188","author":"Rogliani","year":"2021","journal-title":"Respir Med"},{"key":"2024051320303207000_78.8.745.5","article-title":"Combination fixed-dose beta agonist and steroid inhaler as required for adults or children with mild asthma","volume":"5","author":"Crossingham","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"2024051320303207000_78.8.745.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1715274"},{"key":"2024051320303207000_78.8.745.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1901963"},{"key":"2024051320303207000_78.8.745.8","unstructured":"Global Initiative for Asthma . 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