Effect of different asthma treatments on risk of cold-related exacerbations

Research output: Contribution to journalArticle


Common colds often trigger asthma exacerbations. The present study compared cold-related severe exacerbations during budesonide/formoterol maintenance and reliever therapy, and different regimens of maintenance inhaled corticosteroids (ICS), with or without long-acting beta(2)-agonists (LABA), and with as-needed short-acting beta(2)-agonists (SABA) or LABA. Reported colds and severe exacerbations (defined by oral corticosteroid use and/or hospitalisation/emergency room visit) were assessed for 12,507 patients during 6-12 months of double-blind treatment. Exacerbations occurring <= 14 days after onset of reported colds were analysed by a Poisson model. The incidence of colds was similar across treatments. Asthma symptoms and reliever use increased during colds. Budesonide/formoterol maintenance and reliever therapy reduced severe cold-related exacerbations by 36% versus pooled comparators plus SABA (rate ratio (RR) 0.64; p=0.002), and for individual treatment comparisons, by 52% versus the same maintenance dose of ICS/LABA (RR 0.48; p < 0.001); there were nonsignificant reductions versus higher maintenance doses of ICS or ICS/LABA (RR 0.83 and 0.72, respectively). As-needed LABA did not reduce cold-related exacerbations versus as-needed SABA (RR 0.96). Severe cold-related exacerbations were reduced by budesonide/formoterol maintenance and reliever therapy compared with ICS with or without LABA and with as-needed SABA. Subanalyses suggested the importance of the ICS component in reducing cold-related exacerbations. Future studies should document the cause of exacerbations, in order to allow identification of different treatment effects.


  • H. K. Reddel
  • C. Jenkins
  • S. Quirce
  • M. R. Sears
  • E. D. Bateman
  • P. M. O'Byrne
  • M. Humbert
  • R. Buhl
  • T. Harrison
  • G. G. Brusselle
  • A. Thoren
  • U. Sjobring
  • S. Peterson
  • O. Ostlund
  • Göran Eriksson
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Respiratory Medicine and Allergy


  • Asthma, drug therapy, exacerbations, respiratory tract infections
Original languageEnglish
Pages (from-to)584-593
JournalEuropean Respiratory Journal
Issue number3
Publication statusPublished - 2011
Publication categoryResearch