British Lung Foundation
33,714 members41,192 posts

Symbicort versus Advair (No I am not an advocate for either Pharma! merely making info available)

MISSISSAUGA, ON, June 17, 2013 /CNW/ - A second analysis of data from real-world study PATHOS, recently published in the British Medical Journal, shows that treatment of chronic obstructive pulmonary disease (COPD) patients with SYMBICORT® (budesonide/formoterol) was associated with a lower incidence of pneumonia and pneumonia related death, compared to treatment of COPD patients with ADVAIR® (fluticasone/salmeterol).i PATHOS is the largest real-world study to compare the effectiveness and safety of two commonly prescribed inhaled corticosteroid and long-acting beta agonist (ICS/LABA) combination treatments for COPD with more than one year of patient follow-up.i

Overall, the ADVAIR® treatment group was associated with a 73% higher pneumonia rate (rate ratio [RR] 1.73 [95% confidence interval [CI] 1.57-1.90]; p® group.i Similarly, the ADVAIR® treatment group was associated with 74% higher pneumonia-related hospital admissions than the SYMBICORT® treatment group (RR 1.74 [95% CI 1.56-1.94]; p® treatment group compared to 4.3 hospitalizations per 100 patient-years in the SYMBICORT® treatment group.i A corresponding 82% increase in hospital days (53 versus 29 days per 100 patient-years, respectively; p® treatment group.i

The average duration of pneumonia-related hospitalizations was similar for both groupsi but the ADVAIR® treatment group was associated with a higher risk of pneumonia-related death (97 deaths) compared to the SYMBICORT® treatment group (52 deaths) (hazard ratio [HR] 1.76; 95% CI 1.22-2.53; p=0.0025).i

"As a frequent complication of COPD, pneumonia is associated with considerable health cost and mortality" said Dr. Charlie Chan, Professor and Vice-Chair of Medicine, University of Toronto, consultant Respirologist, University Health Network. "This data is significant as it is the first to compare pneumonia rates between two commonly prescribed ICS/LABA combinations in the same matched COPD study population, and can help uncover gaps in care, providing additional information on the efficacy and safety of treatments as experienced in the real-world setting."

A previous analysis of PATHOS data regarding the risk of COPD related moderate and severe exacerbations and hospitalizations was published earlier this year in the Journal of Internal Medicine.ii Together, these analyses of real-world evidence provide insight into the impact of the two treatment combinations in clinical practice, providing healthcare providers, patients and payers with valuable information to further inform their treatment decisions.

The 11-year PATHOS study, led by Uppsala University, retrospectively examined the medical records of 5,468* ICS/LABA-treated patients in Sweden from 1999 to 2009; a total of 19,000 patient years.i This second published analysis of the data compares the rate of pneumonia associated with two commonly prescribed combinations.i To allow for a valid comparison, a cohort of patients treated with ADVAIR® were individually matched with an equal number of patients treated with SYMBICORT®, a second ICS/LABA.i Investigators used a statistical technique called "propensity score matching" to minimize bias and ensure the two ICS/LABA-treated groups were comparable in terms of variables including age, gender, and measures of disease severity such as medication use, COPD co-morbidities, previous hospitalizations for any cause and exacerbation rates for COPD, and other conditions like respiratory infections prior to the first ICS/LABA prescription.i

10 Replies

This is a press release published in the Wall Street Journal:

SOURCE: AstraZeneca Canada Inc.

A disclaimer at the end says "The Wall Street Journal news department was not involved in the creation of this content."

Look at the company: - "What We Do: As a global biopharmaceutical company, our activities touch many people’s lives..."

I have a feeling they may be pretty biased towards their own products...? They just happen to make SYMBICORT® TURBUHALER® ;)


I Have Question Was Reading About Steroid Inhalers ..... And Long Term Use Can Rot Your Lungs ...... Obv A Was Shocked As It Talked About Muscles Rotting Away

Do You Think Its True And Have Any Of Use Seen Read Out Like That ?


i think i asked the some sort of question few months ago where i read steroid inhalers you should not take for a long time but did not say why so i think i was asking if anyone knew why


Unlike randomized, controlled clinical trials, real-world evidence studies use observational data, such as electronic medical records and healthcare registries, to create deeper insights into unmet clinical need, the burden of illness, the cost of care or the actual, rather than expected, impact of management strategies or treatments in a real-world setting. AstraZeneca is committed to understanding the impact of its medicines in the real-world, beyond what is seen in controlled clinical trials. These insights will help AstraZeneca develop medicines that improve the treatment of disease and help inform healthcare decision-making to ensure effective use of medicines that minimize the burden on patients and healthcare


Have to admit, since using symbicort,have had no pneumonia,like I used to get.Coincidence or not??


hi wich is symbicort im on blue ventolin seritde and elkira gunuair,dont want looz muscle or pheumonia ,take care,


hican u break that down .so wich is the worse to take thanks take care


Hi Caroll,

The study is comparing 2 different steroid inhalers (long term preventers), Symbicort and Advair. The company which makes Symbicort have produced a study which claims it is more effective in preventing pneumonia than Advair. This is hardly a surprise in the competitive world of big Pharma. I am on Seretide (the purple one) which is a combination of Salmetorol and Fluticassone the same as Advair. Am I worried. Not by this news. New inhalers are being evaluated all the time and I trust my medical team to give me suitable treatments.

Ps The Ventolin inhaler is a reliever and is often referred to by the drug it contains Salbutamol.


hi war wickstag,im on 500 seritide twice daily,but im only using it once in the morning as it were sending my bones in my hands funny plus burning,i asked gps nurse for a 250 one,no she said keep at it twice a day no im not,all 3 are givin me bad heartburn daily.i have hitus hernia tabs as well ,take care


Also you can read here -