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As-needed use of combination inhaled corticosteroids (ICS) and fast-acting, long-acting β-agonists (LABAs) prevent asthma exacerbations as effectively as daily ICS in patients with mild asthma (NEJM Gen Med Jul 1 2018 and N Engl J Med 2018; 378:1877 and N Engl J Med 2018; 378:1865). Now, in an industry-funded, real-world unblinded study, researchers examined this approach in 670 patients with intermittent mild asthma who were not using ICS currently. Patients were randomized to as-needed budesonide/formoterol (200 μg/6 μg; ICS/LABA group), twice-daily budesonide (200 μg) plus as-needed albuterol (daily-ICS group), or as-needed albuterol (100 μg).
Rates of asthma exacerbations in the as-needed ICS/LABA group and daily-ICS group did not differ…