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The AIR algorithm: a new approach to asthma care based on evidence of better outcomes, safety, and ease of use for patients

February 3, 2020

We have proposed a new treatment model for day-to-day asthma care: the anti-inflammatory reliever therapy based algorithm (AIR algorithm for short), based on a 2-in-1 combination inhaler.

Day-to-day asthma care usually involves taking two types of medicines:

  1. Maintenance: regular scheduled treatment to control asthma symptoms and reduce the risk of asthma attacks.
  2. Reliever: ’top-up’ treatment to relieve asthma symptoms when they occur, including flares of disease, which are often called ‘asthma attacks’

Until very recently, the standard reliever treatment has been a ‘beta agonist’ like salbutamol – an inhaled medicine which relaxes tight airways to make breathing easier. This helps relieve asthma symptoms but doesn’t do anything about the actual cause, which is airway inflammation.

Steroid inhalers are often prescribed regularly to reduce inflammation and the risk of severe asthma attacks. However, it is known that patients often do not take these as regularly as prescribed, seriously limiting their benefit.

When compared to traditional approaches using beta-agonist relievers alone, research has found that taking a beta-agonist and a steroid in one inhaler (a 2-in-1 combination inhaler) has many advantages; patients have fewer severe asthma attacks and require a lower overall dose of steroids. This reduces the risk of serious side effects from long term steroid treatment such as diabetes, osteoporosis, and cataracts. This approach may also be less of a burden on patients’ lives with fewer inhalers to take each day. 

Based on this evidence of better outcomes, safety, and ease-of-use for patients, we have proposed a new treatment model around a single 2-in-1 combination inhaler.

You can read more about it here in our open-access article in the European Respiratory Journal: http://bit.ly/AIR-algorithm