{"doi":"10.1016/j.jaip.2024.06.037","title":"Albuterol-budesonide rescue reduces progression from asthma deterioration to severe exacerbation","abstract":"Clinical ImplicationsDuring an asthma deterioration, patients experience increased symptoms and use more rescue inhaler. By using an albuterol-budesonide inhaler for rescue, patients receive more anti-inflammatory therapy when most needed, reducing the risk of a deterioration progressing to a severe exacerbation. During an asthma deterioration, patients experience increased symptoms and use more rescue inhaler. By using an albuterol-budesonide inhaler for rescue, patients receive more anti-inflammatory therapy when most needed, reducing the risk of a deterioration progressing to a severe exacerbation. Patients with all asthma severities and levels of control are susceptible to exacerbations, even those with high adherence to maintenance therapy.1Lanz M. Pollack M. Gilbert I. Gandhi H. Tkacz J. Lugogo N. Asthmatic patients are at risk for exacerbations irrespective of control, maintenance adherence, or disease severity.Ann Allergy Asthma Immunol. 2022; 129S47Abstract Full Text Full Text PDF Google Scholar Before an asthma exacerbation, symptoms and short-acting β2-agonist (SABA) rescue use increase and peak expiratory flow decreases.2Tattersfield A.E. Postma D.S. Barnes P.J. Svensson K. Bauer C.A. O’Byrne P.M. et al.Exacerbations of asthma: a descriptive study of 425 severe exacerbations. The FACET International Study Group.Am J Respir Crit Care Med. 1999; 160: 594-599Crossref PubMed Google Scholar This provides a “window of opportunity” to potentially prevent exacerbation occurrence and avoid systemic corticosteroids (SCS) by treating symptoms and inflammation concomitantly with an inhaled corticosteroid (ICS) and fast-acting bronchodilator, as advocated by the Global Initiative for Asthma (GINA), the National Asthma Education and Prevention Program (NAEPP), and the European Respiratory Society (ERS).3National Asthma Education and Prevention Program, NAEPP Asthma Management Guidelines: focused updates 2020, 2020.https://www.nhlbi.nih.gov/resources/2020-focused-updates-asthma-management-guidelinesDate accessed: March 7, 2023Google Scholar, 4Global Initiative for Asthma, GINA Global Strategy for Asthma Management and Prevention, 2023.https://ginasthma.orgDate accessed: March 7, 2023Google Scholar, 5Papi A. Ferreira D.S. Agache I. Baraldi E. Beasley R. Brusselle G. et al.European Respiratory Society short guidelines for the use of as-needed ICS/formoterol in mild asthma.Eur Respir J. 2023; 622300047Crossref PubMed Scopus (17) Google Scholar Although GINA, NAEPP, and ERS include ICS-formoterol in their recommendations for both maintenance therapy and as rescue for many patients, no ICS-formoterol product is approved by the US Food & Drug Administration (FDA) for use in this manner. Albuterol-budesonide 180/160 μg pressurized metered-dose inhaler (pMDI) was approved in 2023 by the US FDA for the as-needed treatment or prevention of bronchoconstriction and to reduce the risk of exacerbations for patients with asthma 18 years and older.6AstraZeneca, AIRSUPRA: Highlights of Prescribing Information.https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/214070s000lbl.pdfDate: 2023Date accessed: July 27, 2023Google Scholar SABA-ICS was subsequently included in the GINA 2023 report as an alternative rescue option at all therapy steps for patients 12 years or older.4Global Initiative for Asthma, GINA Global Strategy for Asthma Management and Prevention, 2023.https://ginasthma.orgDate accessed: March 7, 2023Google Scholar MANDALA was a phase 3, randomized, double-blind trial, which demonstrated that as-needed albuterol-budesonide 180/160 μg pMDI significantly reduced severe exacerbation risk by 27% and mean annualized total SCS exposure by 33% versus as-needed albuterol 180 μg in patients 12 years or older with uncontrolled moderate-to-severe asthma receiving ICS-containing maintenance therapies.7Papi A. Chipps B.E. Beasley R. Panettieri Jr., R.A. Israel E. Cooper M. et al.Albuterol-budesonide fixed-dose combination rescue inhaler for as","journal":"The Journal of Allergy and Clinical Immunology In Practice","year":2024,"id":461104,"datarank":0.20794415416798362,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"self_citation_contribution":0.20794415416798362,"citation_network_contribution":0.0,"self_endowment_contribution":0.20794415416798362,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9495,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":434301,"name":"Alberto Papi","orcid":"0000-0002-6924-4500","position":1,"is_corresponding":false},{"id":1041368,"name":"Richard Beasley","orcid":"0000-0003-0337-406X","position":2,"is_corresponding":false},{"id":281778,"name":"Elliot Israel","orcid":"0000-0002-2470-856X","position":3,"is_corresponding":false},{"id":247084,"name":"Reynold A. 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