Work

As-needed inhaled corticosteroids in asthma: from evidence to implementation

Year: 2026

Type: article

Abstract: PURPOSE OF REVIEW: This review aims to clarify the role of as-needed ICS through the severity spectrum of adult asthma and explores the challenges associated with implementation. This review is timely following the recent US Food and Drug Administration (FDA) approval of an ICS/SABA combination inhaler. RECENT FINDINGS: In 2019, the Global Initiative for Asthma (GINA) recommended against the use of short-acting beta agonist (SABA) monotherapy and officially endorsed the use of as-needed inhaled corticosteroid with a fast-acting bronchodilator [anti-inflammatory reliever (AIR)] as the preferred strategy across all treatment steps. In 2020, the US NHLBI asthma guidelines recommended ICS+SABA at step 2, and ICS/formoterol to be used as maintenance and reliever therapy (MART) at treatment steps 3 and 4. Despite these strong recommendations, uptake of this strategy in the United States has been slow. Barriers to MART implementation are explained, and implementation strategies are reviewed. SUMMARY: Transition to a single ICS/formoterol inhaler as MART from traditional multiinhaler regimens offers the opportunity for multidomain benefits. The role of novel ICS/SABA combination inhalers remains to be determined across the continuum of asthma.

Source: Current Opinion in Pulmonary Medicine

DOI: 10.1097/mcp.0000000000001260

Authors: Eric Merrell, Sandhya Khurana

Institution: University of Rochester Medicine

Language: English

Topic: Asthma and respiratory diseases

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

Funder: National Institutes of Health