[IS AS NEEDED THERAPY WITH AN INHALED BUDESONIDE/FORMOTEROL COMBINATION ONLY WHEN SYMPTOMATIC AS AN OPTION IN THE...

As needed therapy with inhaled corticosteroid plus fast onset acting β₂ agonist only when symptomatic (as needed FABA/ICS) is recommended for the management of patients with mild asthma in the various foreign countries based on solid evidence. However, this treatment is currently not recommended in Japan. Therefore, we conducted a systematic review (SR) to determine whether this treatment is beneficial for patients with mild asthma in Japan. We extracted randomized controlled trials (RCTs) that met the following criteria: patients with mild asthma receiving as needed FABA/ICS and assessed at 54 weeks. RCTs were selected from a previously published SR, and the search was up-to-date as of March 2021. In addition, RCTs published until June 2022 were searched. We selected five RCTs from a previously published systematic review and did not select any additional RCTs. As needed FABA/ICS therapy significantly reduced the number of exacerbations requiring systemic steroid and the annual exacerbation rate compared to as needed FABA therapy (p≤0.01), but there was no significant difference with regular ICS therapy. In addition, as needed FABA/ICS therapy significantly reduced the number of exacerbations requiring hospital admission or emergency department / urgent care visit compared to as needed FABA therapy and regular ICS therapy (p≤0.01). The frequency of serious adverse events was not significantly different from as needed FABA therapy and regular ICS therapy. It was suggested that as required FABA/ICS is a useful treatment option in Japanese patients with mild asthma.