Asthma in adults and adolescents: what’s new for mild asthma management?

A new approach offers an alternative to low-dose inhaled corticosteroids for maintenance treatment in adults and adolescents.

 

For consumers, check out Asthma explained

Key points

  • A new approach has been introduced as an alternative to low-dose inhaled corticosteroids for maintenance treatment in adults and adolescents. The Australian Asthma Handbook also discusses the revisions to the stepwise management of asthma.
  • As-needed budesonide–formoterol reliever therapy is now included as an option for the treatment of mild asthma in adults and adolescents.
  • Regular daily inhaled corticosteroids remain an appropriate treatment strategy for most patients.
 

Medicinewise News: Mild asthma - practical considerations and a new treatment option

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Discussing practical considerations with people with mild asthma, such as cost, perception of risk and inhaler technique can help to enable self-management education and shared decision making. We also discuss what to consider with the new treatment option of as-needed low-dose budesonide + formoterol as a reliever for people with mild asthma.

Read the full article

 

Webinar: New asthma guidelines: what’s changed?

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Important changes to the way mild asthma can be managed for patients aged 12 years and over have been announced with the release of the Australian Asthma Handbook V2.1.

This webinar brings together a multidisciplinary panel of experts to discuss:

  • Australian asthma guideline changes for the management of mild asthma in adults and adolescents (12 years and over)
  • where the changes fit in clinical practice and what they mean for health professionals and consumers
  • ensuring a patient-centred approach to decision-making about treatment options.

Find out more

  • Australian asthma guideline changes for the management of mild asthma in adults and adolescents (12 years and over)
  • where the changes fit in clinical practice and what they mean for health professionals and consumers
  • ensuring a patient-centred approach to decision-making about treatment options.
 
 

Australian Prescriber

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Updated Australian guidelines for mild asthma: what’s changed and why?
Helen K Reddel
Aust Prescr 2020;43:220-4

The Australian asthma guidelines have recently been updated and include additional treatment options for adults and adolescents with mild asthma.

Read the full article

Managing the overlap of asthma and chronic obstructive pulmonary disease
Anne Knight
Aust Prescr 2020;43:7–11

Approximately 20% of patients with obstructive lung disease have features of both asthma and chronic obstructive pulmonary disease.

These patients have a higher burden of disease and increased exacerbations compared to those with asthma or chronic obstructive pulmonary disease alone.

Read the full article

 

RADAR: Budesonide with formoterol for mild asthma: New PBS listings

Adults and adolescents with mild asthma can now access anti-inflammatory reliever therapy through the PBS. The new PBS listings complement the recent changes to asthma guidelines. We discuss the clinical evidence around why these changes were made and how this will affect current prescribing.

Read the full article

For your patients

This checklist covers most of the commonly used inhalers available for the treatment of asthma. Use this resource to teach, check and/or confirm the way your patients use their inhalers.

Find out how to get ready for a spirometry test with this fact sheet.

Getting ready for spirometry

Date published : 10 February 2021


This resource explains which medicines are used for relieving asthma symptoms and which ones are used as preventers.

Medicines for treating asthma

This resource discusses symptoms, causes, diagnosis, triggers of asthma and the importance of having an asthma action plan.

Asthma explained

 

Clinical resources and tools

Research summary

Reference

Summary

Symbicort Given as Needed in Mild Asthma (SYGMA) 1

SYGMA 2

The SYGMA 1 and 2 trials have led to major changes in the Global Initiative for Asthma (GINA) guidelines.

Some of the findings from SYGMA 1 showed that as-needed low-dose budesonide with formoterol was superior to as-needed terbutaline in achieving asthma control (well-controlled asthma weeks) and in reducing asthma exacerbations.

SYGMA 2 showed similar results and that as-needed low-dose budesonide with formoterol was non-inferior to low-dose budesonide maintenance treatment in preventing severe asthma exacerbations.

Novel START

The Novel START trial applied the findings of the highly controlled SYGMA trials to reflect real world practice using an open-label regimen. Patients in this trial also had less severe asthma by comparison.

As-needed low-dose budesonide with formoterol reduced the risk of asthma exacerbations compared to salbutamol alone.

PRACTICAL

The PRACTICAL study was an open-label trial which produced similar results to the trials discussed above. It showed improved efficacy with using as-needed low-dose budesonide with formoterol in reducing severe exacerbations for patients with mild to moderate asthma.

Suissa et al 1994

Stanford et al 2012

These studies discuss how overuse of relievers increase the risk of severe asthma flare-ups and asthma mortality.