New research on adults with mild asthma has found using combination medication as needed more effective than just a reliever, or both preventer and reliever, as per current guidelines.
A New Zealand-led international study of mild asthma in adults has found that patients using Symbicort combination medication “as needed” had half as many asthma episodes (exacerbations) as those using a Ventolin reliever.
They also had 56 per cent fewer severe exacerbations than those using just the reliever, and 60 per cent fewer than those using two inhalers – a Pulmicort preventer twice a day plus puffs as-needed from a Ventolin reliever.
"The findings from the study are exciting and have the potential to be a game changer in the way doctors treat mild asthma," said Wellington researcher Professor Richard Beasley, the first author on the four-country study published in the United States in the prestigious New England Journal of Medicine.
Beasley said the trial showed that those on the as-needed combined inhaler “do a lot better” than those on the regimen advocated by current guidelines.
“The greater benefit was achieved despite exposure to less than half the amount of inhaled corticosteroid preventer medication, because the inhaled corticosteroid works better when taken as needed in mild asthma.
“This novel approach simplifies treatment as it doesn’t require patients to take a preventer inhaler twice daily even when they have no symptoms.
"With a combined preventer-reliever inhaler, patients have more personal and immediate control over their asthma management. This takes advantage of the patient's natural behaviour to take a reliever only when they are experiencing symptoms.”
Asthma and Respiratory Foundation medical director Dr Stuart Jones, a respiratory physician, said the Beasley study would lead to a re-think of the New Zealand guidelines on the management of mild asthma.