Stepping Down to As-Needed Treatment for Stable Asthma

For patients with mild asthma, guidelines recommend as-needed use of inhaled corticosteroids (ICS) with a fast-acting beta-agonist (FABA) such as albuterol (which is only fast-acting) or formoterol (which is both fast-acting and long-acting). For our patients with stable asthma on scheduled ICS, is stepping down to an as-needed approach safe and effective? To find out, researchers performed a systematic review and meta-analysis of trials comparing outcomes between patients with stable asthma who continued daily ICS plus as-needed FABA and those who switched to only as-needed ICS/FABA. They identified 7 randomized trials with nearly 2500 patients.