Research Shows a Combo Inhaler May Reduce Need For Oral Corticosteroids
Inhalers that include both a corticosteroid and a beta2 agonist may reduce the risk of asthma flare-ups requiring oral steroids better than a corticosteroid-only inhaler. A recent review looked at three large randomized studies involving 4,209 adults who were on higher doses of maintenance inhaled corticosteroid treatment.
The studies compared the combination treatment, called single-inhaler therapy, with fixed-dose inhaled corticosteroids for maintenance. Single-inhaler therapy reduced the overall amount of steroid needed, both in terms of additional oral courses of steroids and the average daily dose of inhaled steroid. Single-inhaler therapy also improved lung function and reduced the risk of severe asthma exacerbations. But it did not significantly reduce the risk of hospitalization for an asthma flare-up.
Current guidelines recommend the addition of a beta2 agonist when needed for quick relief. In this review, five studies involving 5,378 patients failed to find a benefit for single-inhaler therapy compared with current best practice. Single-inhaler therapy shows clear advantages compared with inhaled corticosteroids alone but is less convincing compared with current guidelines.
Results from five large trials have yet to be published and should provide doctors with additional guidance regarding single-inhaler therapy.
Source: The Cochrane Database of Systemic Reviews, April 15, 2009