Virtual Trial Indicates Combination Rescue Inhaler Significantly Reduces Severe Asthma Attacks

A pioneering virtual clinical trial conducted by Rutgers University and collaborating institutions reveals that adding an inhaled corticosteroid to rescue therapy can dramatically decrease the risk of severe asthma attacks among individuals with mild asthma. The study, published in the New England Journal of Medicine and showcased at the American Thoracic Society conference, evaluated Airsupra, a fixed-dose inhaler combining the anti-inflammatory steroid budesonide with the bronchodilator albuterol. Traditionally, albuterol alone is used as the standard rescue medication during asthma attacks.

In this randomized phase III trial, 2,421 participants experienced asthma exacerbations and were assigned to use either the combination inhaler or albuterol alone. Results showed that only 5.1% of those using Airsupra faced severe attacks requiring hospitalization or urgent medical care, compared to 9.1% of those using albuterol alone. The findings suggest that this dual therapy can halve the risk of severe exacerbations and substantially improve quality of life for many patients.

The trial’s innovative design was conducted entirely remotely, with participants enrolling online, receiving inhalers via courier, and conducting follow-up consultations through telehealth—eliminating the need for travel and reducing costs. Experts believe this approach will accelerate future clinical research, making it more accessible and efficient.

Additional benefits of Airsupra include a 53% reduction in annual exacerbation rates and a 63% decrease in systemic steroid use, thereby lowering the risk of steroid-related complications like diabetes and fractures. Side effects were similar between groups, mostly limited to common respiratory infections.

Airsupra received approval in the U.S. last year for moderates to severe asthma. The new evidence extends its potential use to adolescents aged 12 and older, targeting the roughly 30% of mild asthma patients who still experience frequent exacerbations and face increased risk of serious outcomes. As current guidelines discourage the use of albuterol alone for rescue, health experts anticipate rapid adoption of this combined therapy, potentially transforming asthma management practices.

This study underscores how innovative, remote trial designs can improve healthcare research, enhance patient access, and deliver compelling evidence to inform clinical decisions, ultimately aiming to prevent hospitalizations and improve lives.