Anti-Inflammatory Reliever Therapy in Asthma: A Review

Anti-inflammatory reliever (AIR) therapy is the use of a combination 2-in-1 inhaler which includes a corticosteroid and a fast-onset beta₂-agonist, as a reliever therapy in asthma. The clinical research of its use to date has primarily involved the inhaled corticosteroid (ICS) budesonide together with the long-acting beta₂-agonist (LABA) formoterol, and budesonide with the short-acting beta₂-agonist (SABA) albuterol (salbutamol). Based on high-quality evidence from randomised controlled trials of a substantial reduction in the risk of severe exacerbations, New Zealand and international guidelines recommend ICS/formoterol as the preferred reliever inhaler for use by adolescents and adults with asthma, across the range of asthma severity, rather than SABA reliever-based regimens. Recently, international guidelines have also recommended ICS/SABA reliever as an alternative to a SABA reliever. These recommendations represent the most important paradigm change in asthma management for decades.