Episode 954: Combo Rescue Inhalers - New Guidelines
Apr 30, 2025
Discover the latest in asthma management with combination rescue inhalers. These innovative inhalers not only deliver fast relief but also include a corticosteroid to combat chronic inflammation. Learn about the benefits of this new approach, including research findings that highlight reduced severe episodes. However, the cost and potential side effects like thrush pose challenges. Tune in to understand why global guidelines now favor this treatment for adults and adolescents.
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Combo Rescue Inhalers Cut Exacerbations
Combination rescue inhalers contain both a fast-acting bronchodilator and an inhaled corticosteroid.
They reduce severe asthma exacerbations more effectively than albuterol alone, decreasing risks by 5-10%.
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Prescribe Combo Inhalers for Rescue
Prescribe formoterol plus budesonide inhalers as rescue treatment for asthma instead of albuterol alone.
Educate patients that these combinations both relieve attacks and prevent future exacerbations.
insights INSIGHT
Cost Challenges of Combo Inhalers
Combination inhalers usually cost more than albuterol-only inhalers, posing affordability challenges.
Insurance coverage often determines patient access to these beneficial combination therapies.
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A rescue inhaler is a medication for people with asthma to quickly reverse the symptoms of an asthma attack.
Historically albuterol (Short Acting Beta Agonist (SABA)) monotherapy has been the mainstay rescue inhaler. This is because albuterol works fast and is relatively cheap. \n\n
What are Combination Rescue Inhalers?
Combination rescue inhalers contain a fast-acting bronchodilator as well as an inhaled corticosteroid (ICS)
The steroid helps to reduce some of the chronic airway inflammation that is worsening the asthma attack and can help to prevent future attacks
Examples include budesonide-formoterol and albuterol-budesonide
Global Initiative for Asthma (GINA), states that combination therapy is now the preferred reliever for adults and adolescents with mild asthma
What are the drawbacks of Combination Rescue Inhalers?
These inhalers are generally more expensive than just using a SABA inhaler which can be a barrier for some people \n\n
Improper use can also lead to conditions like thrush due to the addition of the steroid
References
Krings JG, Beasley R. The Role of ICS-Containing Rescue Therapy Versus SABA Alone in Asthma Management Today. J Allergy Clin Immunol Pract. 2024 Apr;12(4):870-879. doi: 10.1016/j.jaip.2024.01.011. Epub 2024 Jan 17. PMID: 38237858; PMCID: PMC10999356.
Papi A, Chipps BE, Beasley R, Panettieri RA Jr, Israel E, Cooper M, Dunsire L, Jeynes-Ellis A, Johnsson E, Rees R, Cappelletti C, Albers FC. Albuterol-Budesonide Fixed-Dose Combination Rescue Inhaler for Asthma. N Engl J Med. 2022 Jun 2;386(22):2071-2083. doi: 10.1056/NEJMoa2203163. Epub 2022 May 15. PMID: 35569035.
Summarized by Jeffrey Olson, MS3 | Edited by Jorge Chalit, OMS3 \n\n
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