A Shift Toward Combining Inhaled Corticosteroids and β-Agonists for Asthma Rescue Therapy

Overuse of albuterol is associated with excess risk for severe asthma exacerbations. Global Initiative for Asthma (GINA) guidelines recommend avoiding albuterol for all patients and using inhaled corticosteroids (ICS)/formoterol as a rescue inhaler. Although the National Asthma Education and Prevention Program (NAEPP) guidelines have not gone that far, they do recommend using as-needed ICS/albuterol for mild asthma.

In a multinational trial, more than 3100 adolescents and adults with uncontrolled moderate-to-severe asthma were randomized to either high- or low-dose albuterol/budesonide (180/160 µg or 180/80 µg) or albuterol alone (180 µg) as a rescue inhaler while continuing their current ICS or ICS/LABA (long-acting β-agonist) therapy. Afte…