Inhaled Steroids as Rescue Therapy in Mild Persistent Asthma?

In the absence of clear guidelines for discontinuation of daily inhaled corticosteroid (ICS) controller therapy in children with well-controlled mild persistent asthma, children and their families often stop such therapy on their own, risking increased exacerbations. Some studies suggest that ICS can reduce exacerbation frequency when combined with a bronchodilator as rescue therapy, rather than as daily controller therapy.

In a 44-week placebo-controlled trial, investigators randomized 288 children and adolescents (age range, 6–18 years) with mild persistent asthma to receive inhaled beclomethasone (40 µg twice daily) as a controller drug, inhaled beclomethasone (80 µg) along with every rescue dose of inhaled albuterol, both, or neither. Al…