ANALISIS PENGARUH PEMBERIAN BUDESONIDE TUNGGAL DAN KOMBINASI BUDESONIDE-FORMOTEROL TERHADAP NILAI ASTHMA CONTROL TEST (ACT) DAN FEV1 PADA PENDERITA ASMA BRONKHIAL

Asthma remains a major chronic respiratory burden, and inhaled corticosteroid (ICS) therapy is the cornerstone of long-term control. Whether initiating newly diagnosed patients on a budesonide–formoterol (ICS–long-acting β2-agonist) combination delivered through a single inhaler accelerates control compared with budesonide monotherapy has been poorly documented in Indonesian real-world settings. This prospective two-arm cohort study enrolled 44 ICS-naïve adults (18–55 years) with newly diagnosed bronchial asthma in Makassar, allocated by treating- physician decision to budesonide monotherapy (n = 22) or budesonide–formoterol (n = 22). The Asthma Control Test (ACT) score and forced expiratory volume in one second (FEV1) were measured at baseline and at months 1, 2 and 3. Numerical variables are reported as median (interquartile range) and compared using the Mann–Whitney U test; within-group change was assessed by the Friedman test with Wilcoxon post-hoc analysis. The groups were comparable at baseline (ACT 14.0 vs 13.5; p = 0.322). Both regimens improved ACT progressively (Friedman p < 0.001 for each). The combination produced significantly higher ACT scores from month 1 (19.0 vs 16.0; p = 0.001; r = 0.587), widening by month 3 (23.0 vs 19.5; p < 0.001; r = 0.707; Hodges–Lehmann median difference 3.0 points, 95% CI 2.0–4.0) and reaching the 3-point minimal clinically important difference. The greatest separation occurred during the first month (ΔACT 5 vs 3; p < 0.0001; r = 0.926). By month 3, no combination-group patient remained uncontrolled, versus 31.8% on monotherapy (p = 0.009); FEV1 was also consistently higher with the combination. Early budesonide– formoterol delivered meaningfully faster asthma control, and a first-month ACT assessment may identify patients requiring early treatment escalation.