A new approach to asthma management.

What is it about?

There are several paradoxes in current asthma management which were outlined in a recent ERJ publication. This further ERJ paper describes another five paradoxes which focus predominantly around the use of short-acting beta2-agonists (SABAs) across the spectrum of asthma severity. Evidence is presented to advocate the replacement of SABAs with alternatives such as combination inhaled corticosteroid(ICS)/fast-onset SABAs and ICS/fast-onset long-acting beta2-agonists (LABAs) used as reliever therapy, which have shown superior efficacy and safety.

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Why is it important?

The potential long-term adverse effects from self-administered SABA for symptomatic relief of bronchoconstriction needs to be considered. Further clinical research investigating the efficacy and safety of combination ICS/fast-onset beta2-agonist reliever therapy is required across asthma of all severities, in both children and adults. A review of current asthma management guidelines is warranted, with consideration given to replacing SABA reliever therapy with combination ICS/LABA and ICS/SABA reliever inhaler therapy.