Advancing Asthma Management: Experts Advocate for ICS-Containing Rescue Therapy

In a recent invited review published in the esteemed journal JACI: In Practice, Assistant Professor James Krings from the Division of Pulmonary and Critical Care at Washington University in St. Louis School of Medicine and Professor Richard Beasley Director of the Medical Research Institute of New Zealand (MRINZ) examine the changing dynamics of asthma care, questioning the conventional practice of relying solely on short-acting beta2-agonist (SABA) treatments in mild asthma.

As part of The Journal of Allergy and Clinical Immunology's 'Controversies in Allergy' series, their review underscores the Global Initiative of Asthma's (GINA) recommendations, advocating for the adoption of combination inhaled corticosteroid (ICS)-formoterol as the preferred reliever therapy for mild asthma in adults and adolescents.

The review highlights the substantial reduction in the risk of severe asthma attacks with as-needed ICS-formoterol alone compared to as-needed SABA alone. ICS-formoterol also had a positive impact on symptoms and lung function.  Furthermore, ICS-formoterol's ability to lower Fractional Exhaled Nitric Oxide (FeNO) levels indicates a reduction in airway inflammation with its use, thereby decreasing the severity of the underlying disease process in asthma. With fewer adverse events, particularly those tied to asthma, ICS-formoterol presents a safer alternative compared to SABA therapy.

The review also presented preliminary data on the novel ICS-salbutamol products which have also shown benefits in reducing severe asthma attacks, including in mild asthma.

The authors stressed the importance of now undertaking clinical trials of both ICS-formoterol and ICS-salbutamol reliever therapy in children, to find out if similar benefits occur in this high-risk population.  

Throughout their review, Professors James and Beasley stress the imperative of bridging the gap between theoretical recommendations and practical implementation of ICS-containing reliever therapies, dealing with regulatory obstacles and availability issues in different regions.

Ultimately, this review serves as a clear call for healthcare providers and regulatory bodies to align their practices with evolving asthma management guidelines, underlining the pivotal role of ICS-containing rescue therapy in enhancing patient outcomes and overall quality of life.

Please read the full review, here.