People with asthma have a new option for the treatment of their symptoms, which is a significant change, and the first of its kind for 30 years.
The anti-inflammatory reliever, which will be available as either Symbicort Turbuhaler 200/6, Symbicort Rapihaler 100/3 or DuoResp Spiromax (containing the active ingredients budesonide/formoterol), must be prescribed by a doctor for use in persons over 12 years, or adults 18 years or over in the case of DuoResp Spiromax) with mild asthma to treat symptoms as needed.
The main difference with this new option is that the reliever comes in combination form, providing a dose of corticosteroid at the same time as the medicine which relaxes the airway muscles, the bronchodilator. Studies have found that the addition of this corticosteroid during symptom relief has the potential to significantly reduce the risk of severe flare-ups, or asthma attacks for people who have mild asthma.
The main aim of treatment for asthma is to achieve good asthma control and minimise the risks of asthma flare-ups, attacks, or hospitalisations. In 2019, after significant research into the factors associated with severe asthma flare-ups, the Global Initiative for Asthma (GINA), stimulated a number of research studies testing different treatment approach for people with mild asthma to reduce their risk of severe flare-ups.
This research demonstrated consistently that in place of the standard blue/grey reliever, the use of a combination medicine containing a corticosteroid and long-acting bronchodilator with a rapid onset of action significantly reduced the risk of severe asthma flare-ups for people with mild asthma. The anti-inflammatory role of the corticosteroid is believed to explain this.
For years, many people have seen their usual reliever as convenient, safe, and effective. When they get symptoms, they use their reliever, get relief, and associate that with good asthma management. But we know that people who rely too much on their reliever have a higher risk of very severe and even life-threatening asthma attacks. Treatment that doesn’t address airway inflammation is potentially hazardous. Anyone with a diagnosis of asthma should be discussing the right treatment for them, with their doctor, even if symptoms are mild and infrequent. People with symptoms at least 2 times per month should be taking a regular inhaled preventer.
It’s important that people with asthma, no matter how mild, recognise that there is inflammation that underlies the symptoms and that treatment with a medicine that addresses that inflammation is the way to go. The Australian clinical guidelines for asthma treatment, the Australian Asthma Handbook (AAH) by the National Asthma Council, Australia is being adjusted accordingly, which will enable doctors and people with asthma to have informed conversations about the best approach to treating asthma, breathing easily and living freely.
It is important that people with asthma discuss their new options with their doctor and pharmacist to determine whether this new treatment is suitable for them. As usual, if they are using any reliever more than twice per week, or experiencing asthma symptoms at night or on activity, we would strongly recommend discussing your asthma control and asthma treatment with your doctor.