Vidcast:  https://youtu.be/ZIK07yBWRcA

A study just published online by the New England Journal of Medicine is challenging the way we manage asthma.  

For decades, inhalation of the short-acting bronchodilator albuterol, sold as Proventil and Ventolin, has been the recommended treatment for attacks with the addition of an inhaled steroid for maintenance of easy breathing. A collaborative group from New Zealand, Australia, and Britain now demonstrates that the inhaled steroid+long acting bronchodilator combo budesonide-formoterol, marketed as Symbicort, and only used when needed not only works effectively to stop asthma attacks but also prevents them with less steroid exposure for the patient.

The study included 688 adult asthma patients in 3 treatment groups who randomly received either as-needed albuterol, as-needed budesonide-formoterol, or daily budesonide with the addition of albuterol as needed.  The results showed that as-needed steroid+long-acting bronchodilator reduced the incidence of severe asthma attacks by 40% when compared with as-needed short-acting bronchodilator and 44% when compared with daily steroid.  Also important was the finding that only using the steroid when needed versus daily reduced the amount of steroid exposure by by more than half.

The take away: as-needed steroid+long-acting bronchodilator, budesonide-formoterol is more effective and safer for asthma treatment and prevention than as-needed short-acting albuterol or daily steroid budesonide with added albuterol when necessary.  

If you or your child is asthma, speak with your doctors about this newer strategy.

Richard Beasley, D.Sc., Mark Holliday, B.Sc., Helen K. Reddel, Ph.D., etal. Controlled Trial of Budesonide–Formoterol as Needed for Mild Asthma.  NEJM Online: May 19, 2019

DOI: 10.1056/NEJMoa1901963

#Asthma #albuterol #budesonide #bronchodilators