Innovative Two-in-One Inhaler Significantly Reduces Childhood Asthma Attacks

A groundbreaking international study has demonstrated that using a combined inhaler containing both an inhaled corticosteroid (budesonide) and a fast-acting bronchodilator (formoterol) as the sole reliever therapy considerably decreases asthma attacks in children aged 5 to 15. In the first randomized controlled trial of its kind, researchers found that the 2-in-1 inhaler was more effective than the traditional salbutamol inhaler, which has been the standard treatment for symptom relief. Specifically, children using the combined inhaler experienced a 45% reduction in asthma attacks, a substantial improvement that can significantly impact their health and quality of life.

The study, known as the CARE trial (Children's Anti-inflammatory REliever), was led by the Medical Research Institute of New Zealand in collaboration with top institutions including Imperial College London, the University of Otago Wellington, and Starship Children's Hospital. Over 360 children from New Zealand participated in the research, which spanned one year. Participants were randomly assigned to receive either the new budesonide-formoterol inhaler or the conventional salbutamol inhaler for on-demand symptom relief.

Results showed that children using the combined inhaler had an average of 0.23 asthma attacks per year, compared to 0.41 attacks with salbutamol, translating to 18 fewer attacks per 100 children annually when switching treatments. Importantly, the safety profile of the new inhaler was comparable to that of salbutamol, with no adverse effects on growth, lung function, or overall asthma control.

Dr. Lee Hatter, lead author, emphasized the significance of these findings in closing the gap between adult and pediatric asthma treatments. "For the first time, we’ve demonstrated that a single picogram inhaler used as needed can effectively reduce attacks in children with mild asthma. This could lead to better management and outcomes worldwide."

Professor Richard Beasley, director of MRINZ, noted that integrating these findings into global guidelines could revolutionize asthma care for children. With over 113 million children affected globally, adopting the 2-in-1 inhaler as a standard relief treatment can help reduce health disparities and optimize outcomes.

The research highlighted some limitations, including the impact of COVID-19 measures on attack rates and challenges in diagnosing attacks in children. Nevertheless, the trial’s real-world design ensures its applicability to clinical settings. Experts like Professor Andrew Bush of Imperial College London and Professor Helen Reddel of GINA stressed the potential of this approach to prevent severe attacks and foster lifelong healthier asthma management habits.

This study builds on previous adult-focused research, which influenced international treatment guidelines. The findings support a shift towards using combined anti-inflammatory inhalers as the primary reliever therapy in children, promising a safer, more effective strategy to combat childhood asthma worldwide.