The timing is more important than the total dose of inhaled corticosteroid in mild asthma
In asthma care, inhaled steroids treat the inflammation driving symptoms, and β2-agonists like Salbutamol relieve symptoms quickly to make breathing easier. We found that by taking these medicines together in a combined inhaler early when symptoms started to flare up, patients were able to better match the amount of steroid taken to their need (rather than taking a fixed daily amount). This resulted in fewer severe asthma exacerbations, a lower overall steroid dose, and fewer days in which they needed to take their inhaler at all.
Our key take-home message is that "the timing of ICS dose when self-titrated to β2-agonist use, through the as-needed use of the combination budesonide/formoterol inhaler, is more important than total ICS dose in reducing severe exacerbation risk in mild asthma."
Read more about it in our new paper published in the European Respiratory Journal here: doi.org/10.1183/13993003.00170-2020