Summary

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• This summary is based on the review of seven systematic review(s)/meta-analysis(es). ^[1-7]
• In moderate-to-severe Chronic obstructive pulmonary disease (COPD) patients, budesonide/formoterol (BF) significantly reduced exacerbations (relative risk (RR) 0.91 [95% confidence interval (CI) 0.83-1.00]; p = 0.040), hospitalizations (RR 0.77 [95% CI 0.67-0.88]; p < 0.001), and pneumonia frequency (RR 0.77 [95% CI 0.64-0.92]; p = 0.05) compared to fluticasone/salmeterol (FS), with no significant effect on emergency department (ED) visits, hospitalization duration, or exacerbation frequency.
• In asthma patients with poorly controlled symptoms, the Single Maintenance and Reliever Therapy (SMART) regimen with budesonide/formoterol delayed time to the first severe exacerbation and reduced risk compared to continued Global Initiative for Asthma (GINA) Step 3-5 treatment with inhaled corticosteroids (ICS) + long-acting beta agonists (LABA) plus short-acting beta agonist (SABA) reliever (hazard ratio (HR) 0.71 [95% CI 0.52-0.97]; HR 0.70 [95% CI 0.58-0.85]).
• For mild asthma, a fixed-dose budesonide/formoterol combination reduced exacerbations requiring systemic steroids (OR 0.45 [95% CI 0.34-0.60]) and hospital admissions/emergency department (ED) visits (OR 0.35 [95% CI 0.20-0.60]), showing better asthma control over fast-acting beta₂-agonist (FABA) alone, with minimal difference compared to regular ICS in exacerbation reduction or control.
• COPD Treatment: BF reduced pneumonia frequency compared to FS (RR 0.77 [95% CI 0.64-0.92]).
• Mild Asthma: FABA/ICS may reduce adverse events (OR 0.82 [95% CI 0.71-0.95]) and total systemic steroid dose; no significant mortality differences observed.
• The population types include moderate-to-severe COPD patients, adults and adolescents with poorly controlled asthma, adolescents and adults with mild asthma, adults, adolescents, and children with chronic asthma, pediatric and adult patients aged 6 and above for asthma, and a general population of asthma and COPD patients in real-world studies.