Reliever medications in asthma: ICS and formoterol

Paul M. O’Byrne, MB, is a professor of medicine and dean and vice-president of the Faculty of Health Sciences at McMaster University.

How to tell which patients will benefit most from the combination of low-dose inhaled corticosteroids (ICS) and formoterol used as needed?

The use of inhaled budesonide and formoterol as needed as a reliever medication has been studied now in asthmatic patients with all degrees of severity of asthma, from the mildest cases through to those with the most severe asthma. In every single study there has been benefit demonstrated over and above the benefit achieved with an inhaled short-acting beta₂-agonist (SABA).

So I think the evidence is sufficiently good to be able to say that every patient with asthma who requires a reliever medication should be using the reliever that contains both an inhaled steroid as well as an inhaled rapid-onset beta₂-agonist.