2-In-1 Inhaler Reduces Asthma Attacks In Children By 45% Shows New Study

2-In-1 Inhaler Reduces Asthma Attacks In Children By 45% Shows New Study

New findings could reshape the treatment for an estimated 113 million children worldwide who have asthma, following this side-by-side comparison of two types of asthma inhalers.

In the first randomized controlled trial to investigate the use of a combination inhaler as the sole reliever for children aged 5 to 15, an international team found the 2-in-1 treatment to be more effective than salbutamol—the current standard for asthma symptom relief in children.

The results show that using an inhaler that combines 2 treatments—the inhaled corticosteroid (ICS) budesonide and the fast-acting bronchodilator formoterol—reduced children’s asthma attacks by an average of 45%, compared to the widely-used salbutamol inhaler.

Asthma attacks in children may be life-threatening and reducing their frequency and severity should be a public health priority.

The 2-in-1 budesonide-formoterol inhaler is widely recommended as the preferred reliever treatment for adults, but children are still usually prescribed salbutamol.

Researchers say the findings, published today in The Lancet, provide the evidence needed to bring children’s global asthma guidelines into line with adults’.

The CARE study (Children’s Anti-inflammatory REliever) was designed and led by the Medical Research Institute of New Zealand, in collaboration with Imperial College London, University of Otago Wellington, and the University of Auckland. It recruited 360 children across New Zealand who were then randomly assigned to use either budesonide-formoterol or salbutamol for on-demand symptom relief.

The trial lasted a year and the budesonide/formoterol reliever resulted in a lower rate of asthma attacks than just salbutamol, with rates of 0.23 versus 0.41 per participant per year.

This means that for every 100 children with mild asthma who are switched from salbutamol to a 2-in-1 budesonide-formoterol inhaler, there would be 18 fewer asthma attacks per year. Importantly, the study also confirmed the safety of the combined-inhaler approach, with no significant differences in children’s growth, lung function, or asthma control between the two groups.

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“For the first time, we have demonstrated that the budesonide-formoterol 2-in-1 inhaler, used as needed for symptom relief, can significantly reduce asthma attacks in children with mild asthma,” said Dr Lee Hatter, lead author of the study and Senior Clinical Research Fellow at the the Institute.

“Implementing these findings could be transformative for asthma management on a global scale,” said senior author Prof. Richard Beasley in the media release.

The latest study builds on previous studies in adults led by MRINZ researchers which contributed to the recommended use of the 2-in-1 ‘ICS–formoterol reliever’ inhaler as the preferred reliever treatment for adults.

“Having an asthma attack can be very scary for children and their parents,” commented Prof. Andrew Bush, from Imperial College London, a respiratory pediatrician and co-author of the CARE study.

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“I’m so pleased that we’ve been able to prove that an inhaler that significantly reduces attacks—already a game-changer for adults—is safe for children with mild asthma as young as five.”

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