The Cochrane Airways Group has determined that use of a fixed dose inhaler containing both a steroid and beta₂‐agonist as required instead of short‐acting beta agonist (SABA) monotherapy as required is clinically effective in adults and adolescents with mild asthma.
In a review of the evidence it found fast-acting beta agonist/inhaled corticosteroid (FABA/ICS) reduced exacerbations requiring systemic corticosteroids (OR 0.45), asthma-related hospital admissions or unscheduled healthcare visits (OR 0.35), exposure to systemic corticosteroids and probably adverse events (OR 0.82).
Given exacerbations are responsible for the majority of morbidity, mortality and the economic costs of asthma, it said the findings support the GINA international guidelines that have previously been reported in the limbic.
Some enthusiastic adopters of GINA’s recommendations have gone as far as calling for a ban on the SABA blue puffer.
The Cochrane review identified five relevant studies which contributed to the meta-analysis. All five studies used budesonide 200 μg and formoterol 6 μg in a dry powder formulation as the combination inhaler.
“There would be value in further trials which assessed other fixed‐dose combinations including formulations with pressurised meter dose inhalers, ultra‐fine particle preparations, and other ICS such as beclomethasone or other FABAs such as salbutamol,” the review authors said.