The effectiveness of Albuterol–Budesonide combination rescue inhaler in asthma management
Reviewed by Dat Tien Nguyen, B.A, ScM. Posted on September 7th, 2022
Albuterol, also known as Salbutamol, is a short-acting inhaled beta2-agonist bronchodilator (SABA) that is commonly used to relieve an asthma attack. In addition, the Global Initiative for Asthma recommends a daily usage of inhaled corticosteroid (ICS) such as budesonide. A recent phase-3 randomized controlled trial conducted by Alberto Papi, M.D. and Bradley E. Chipps, M.D. assess the effectiveness of relief usage with albuterol alone or in combination with a varying dosage of budesonide in preventing severe asthma exacerbation.
The trial included mostly adults - 97% were 12 years of age or older - that are receiving maintenance treatment to prevent asthma attacks. The 3,132 participants were randomly assigned to receive 1) Albuterol (180 ug) alone, or 2) a combination of albuterol (180 ug) and high-dose budesonide (160 ug), or 3) a combination of albuterol (180 ug) and low-dose budesonide (160 ug). When compared to that use only SABA, the high dose combination treatment helps reduce the risk of severe asthma exacerbation by 26%. The higher amount of ICS proves more beneficial, since the risk reduction of the lower dose combination is only 11%. In terms of safety, all three groups reported a similar rate of adverse events ranging from 46.2% to 47.1%. This similarity in rate is consistent in the different types of side effects; thus, the usage of ICS does not significantly increase the risk of oropharyngeal infection such as candidiasis.
According to the clinical guideline published by the VIetnamese Ministry of Health, albuterol, by itself, is usually recommended to relieve asthma attacks. With the benefit and safety of high-dose budesonide supplementation proven, it is possible that adding ICS can enhance the protective effect of the relief treatment.
The trial included mostly adults - 97% were 12 years of age or older - that are receiving maintenance treatment to prevent asthma attacks. The 3,132 participants were randomly assigned to receive 1) Albuterol (180 ug) alone, or 2) a combination of albuterol (180 ug) and high-dose budesonide (160 ug), or 3) a combination of albuterol (180 ug) and low-dose budesonide (160 ug). When compared to that use only SABA, the high dose combination treatment helps reduce the risk of severe asthma exacerbation by 26%. The higher amount of ICS proves more beneficial, since the risk reduction of the lower dose combination is only 11%. In terms of safety, all three groups reported a similar rate of adverse events ranging from 46.2% to 47.1%. This similarity in rate is consistent in the different types of side effects; thus, the usage of ICS does not significantly increase the risk of oropharyngeal infection such as candidiasis.
According to the clinical guideline published by the VIetnamese Ministry of Health, albuterol, by itself, is usually recommended to relieve asthma attacks. With the benefit and safety of high-dose budesonide supplementation proven, it is possible that adding ICS can enhance the protective effect of the relief treatment.