Can Mild Asthma Be Managed with Only As-Needed Inhaled Steroids Plus a Bronchodilator?

Several trials have shown that as-needed therapy with an inhaled corticosteroid (ICS) plus a bronchodilator is at least as effective as daily ICS maintenance therapy for preventing exacerbations in patients with mild asthma. Researchers in New Zealand now have compared these two approaches in an open-label, “real world” study of 885 patients with mild asthma, 70% of whom had been receiving daily ICS therapy.

Patients were randomized either to open-label daily budesonide plus separate as-needed terbutaline or to as-needed budesonide/formoterol in a dry-powder Turbohaler (not available in the U.S.). During 1 year, severe exacerbations that required at least 3 days of oral corticosteroids were 30% less frequent in the as-needed budesonide/formo…