OBJECTIVES: The currently available formulations budesonide/formoterol (BUD/FORM, Symbicort) and salmeterol/fluticasone (SAL/FLU, Seretide) have been shown to be effective in the treatment of asthma. This study compared outcomes with BUD/FORM and SAL/FLU in real-life practice. METHODS: Cohorts of asthma patients initiated on BUD/FORM or SAL/FLU between 2001 and 2006 were identified from IMS Disease Analyzer, a longitudinal UK database of physician records. Patients were followed 12 months before and after treatment initiation (TI). Treatment success was defined as no oral corticosteroid prescription (OCS) or hospitalisation, no change in maintenance therapy and a mean daily short-acting b2-agonist (SABA) consumption <0.5 doses/day. Baseline demographics, co-morbidity and asthma medication before TI was used to construct regression models to control for factors potentially influencing outcomes. RESULTS: Respectively, 2701 and 7320 patients were included in the BUD/FORM and SAL/FLU cohorts, respectively, with no significant difference in age, gender, co-morbidity, ICS dose, SABA use or hospitalisations at baseline while active smokers, asthma consultations and OCS prescriptions were slightly lower in the BUD/FORM group. Use of SABA and asthma consultations decreased in both cohorts following TI. In unadjusted analysis a higher proportion of treatment success was seen in the BUD/FORM group following TI compared to SAL/FLU (25.3 vs. 23.0%, p<0.05). This result was driven by fewer patients in the BUD/FORM group with an OCS prescription and high SABA use. In multivariate binary regression analysis, BUD/FORM was not significantly associated with greater odds of success than SAL/FLU (OR, 95% CI: 1.11, 0.99-1.23). Variables significantly associated with success were age, female sex, no rhinitis and low OCS and SABA use pre TI. Resource use (hospitalisations and asthma consultations) was similar between groups post TI. CONCLUSION: Initiating treatment with BUD/FORM or SAL/FLU in real-life practice improved outcomes to a similar magnitude, although there were trends to better outcomes associated with BUD/FORM.