Symbicort Single Inhaler Therapy vs Conventional Best Practice for the Treatment of Persistent Asthma in Adults

• Total Number of Severe Exacerbations [ Time Frame: Baseline up to 6 months ] [ Designated as safety issue: No ]
  Severe asthma exacerbation is defined as deterioration in asthma leading to at least one of Hospitalization/Emergency room (or equivalent) treatment due to asthma or Oral (GCS) treatment for at least 3 days.
• Mean Use of as Needed Medication [ Time Frame: Baseline up to 6 months ] [ Designated as safety issue: No ]
  Mean use of as needed medication during the treatment period
• Use of Inhaled Steroids [ Time Frame: Baseline up to 6 months ] [ Designated as safety issue: No ]
  Mean micrograms/day of inhaled steroids (beclomethasone dipropionate equivalents)
• Change in the Asthma Control Questionnaire(ACQ) Score [ Time Frame: Daily 14 days prior to each of visit 2-4 ] [ Designated as safety issue: No ]
  The ACQ is a 7-point scale with scores ranging from 0 (very well controlled) to 6 (very badly controlled)
• Peak Expiratory Flow (PEF) [ Time Frame: 6 months (end of the study) ] [ Designated as safety issue: No ]
  Peak expiratory flow (PEF)

This study is intended to extend the knowledge of Symbicort Single Inhaler Therapy into a more general setting in order to assess the real-life impact of introducing this new treatment concept. The study will compare the Symbicort Single Inhaler Therapy concept with a conventional stepwise treatment regimen according to the investigator's judgement in patients who present with symptoms on inhaled glucocorticosteroids (GCS) treatment or who require and are already on treatment with a combination of inhaled and long-acting B2 agonists (LABA).

• Drug: Symbicort (budesonide/formoterol) Turbuhaler
• Drug: Conventional treatment

Inclusion Criteria:

• Minimum of 3 months history of asthma, diagnosed according to the American Thoracic Society (ATS) definition (9).
• Prescribed inhaled GCS at a dose of 400μg/day of budesonide (or equivalents)and within the approved label for the relevant drug during the last 3 months prior to Visit 1.
• Either daily maintenance treatment with both inhaled GCS and LABA or daily treatment with inhaled GCS alone (i.e. without LABA)
• A history of suboptimal asthma control the month prior to enrolment as judged by the investigator
• Use of ≥3 inhalations of as needed medication for symptom relief during the last 7 days before enrolment

Exclusion Criteria:

• Previous treatment with Symbicort Single Inhaler;
• Use of any b-blocking agent, including eye-drops and oral GCS as maintenance treatment.
• Known or suspected hypersensitivity to study therapy or excipients.
• A history of smoking ≥ 10 pack years.
• Asthma exacerbation requiring change in asthma treatment during the last 14 days prior to or at Visit 1.