Letters: Clarifying the use of combinationinhalers

Dear Editor

I read with interest the MRCGP exam update by Dr Louise Newson (GP, 12 May).

Dr Newson summarises the data supporting the use of combination inhalers in asthma.

The article emphasises that 'the combined treatment concept means that patients can use a single inhaler both to prevent asthma attacks and for "as needed" symptom relief'. This generalisation is also highlighted in key points and implication for practice.

We would like to clarify that provision of maintenance and relief treatment is far from a class effect of combination inhalers.

Indeed, the unique pharmacological profile of the Symbicort (formoterol/budesonide) components means that it is the only combination asthma treatment that can potentially be used in this way.

There is no clinical data to support use of any other asthma combination inhaler for use as a rescue treatment.

Furthermore, Symbicort has not yet received its licence for use as a reliever medication. Symbicort maintenance and reliever treatment (SMART) has been submitted into the European Mutual Recognition procedure by AstraZeneca, as an addition to the currently approved dosing regimen for Symbicort.

In the interests of accuracy, we would encourage you to correct any misunderstanding among your readers with regards to this matter.

Dr Jan-Paul Rosen, Medical leader respiratory, AstraZeneca UK Ltd.

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