Authors:
Katherine Montag Schafer, PharmD, BCACP, CDCES
Stefanie C. Nigro, PharmD, BCACP, CDCES

Reviewers:
Kristen Pate, PharmD, BCACP
Margaret Miklich, PharmD, BCACP

Citation:
Papi A, Chipps BE, Beasley R, et al. Albuterol-Budesonide Fixed-Dose Combination Rescue Inhaler for AsthmaN Engl J Med 2022; 386(22): 2071-2083.

The Problem

It is well established that overuse of short-acting beta-agonists (SABA) increases the risk of poor asthma control, exacerbations, and mortality.  Why? Because they do not address the underlying airway inflammation that is the root cause of asthma.1 Despite these data, reliance on SABA has remained the standard of care for rescue therapy … until recent clinical practice guideline updates, which now recommend alternative rescue regimens in some or most patient populations.2-4 Several studies have used alternative rescue treatment regimens that combine both a beta-agonist with an inhaled corticosteroid (ICS). The combination provides relief of symptoms and decreases the risk of poor outcomes.5-9While the majority of these studies provide evidence to support single maintenance and reliever therapy (SMART) with ICS-formoterol, there is still a need to identify other combination rescue regimens to broaden treatment options and reduce barriers to access (e.g., cost and insurance coverage) as well as patient reluctance to change. 

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