Key Summary
- While SABA gives short-term results, LABA reduces inflammation and gives long-term results.
- Currently, more than 1 million people have switched to new inhalers.
- The new inhaler adds quality to patients' life, avoiding frequent hospital visits and admissions.
Asthma patients are now ditching the traditional blue inhaler for combination inhalers that don’t just relieve symptoms, but tackle the underlying inflammation that causes attacks in the first place.
Nearly two years after the guidelines were jointly published by the National Institute for Health and Care Excellence (NICE), the British Thoracic Society (BTS) and the Scottish Intercollegiate Guidelines Network (SIGN), the usage of combination inhalers in England has now overtaken the traditional inhalers and exceeds one million.
It is a tipping point that doctors are calling a life-saving cultural shift in how asthma is treated, and many patients claim they feel much better with new inhalers.
Doctors claim the traditional inhaler, known medically as a short-acting beta2 agonist or SABA, masks the problem without fixing it, and overuse is linked to a higher risk of attacks, hospital admissions and death.
The new inhalers combine an inhaled steroid and a long-acting beta2 agonist (LABA) medicine called formoterol in a single device. They treat the inflammation and prevent flare-ups while also providing immediate relief.
The new treatment plans are known as AIR (Anti-inflammatory Reliever) which uses the inhaler only as needed, and MART (Maintenance and Reliever Therapy), which uses the inhaler daily as well as when needed, for those with more frequent or severe symptoms.
The shift from SABA to AIR or MART inhalers was already under way, but the 2024 guideline has accelerated it considerably.
Dr Sunil Gupta, GP clinical advisor at NICE, said, “Seeing more than a million people already using these new inhalers is genuinely encouraging. We know change takes time, but the direction of travel is right. Better asthma control means fewer emergencies, which is good for patients and good for the NHS.”
According to the NICE data, for every 10,000 switching to LABA inhalers, there would be 1,133 fewer GP visits, 144 fewer people A&E yearly dependence, and 80 fewer people hospital admissions.
However, SABA still has got many takers because of misinformation and for some it may not be suitable as they are not tolerant to it.
“The guideline has led to a significant shift in the management of asthma, focusing on prevention and that will help reduce the risk of attacks. AIR and MART inhalers are suitable for most people with asthma, not just those with poor control,” said Donna Peat, respiratory advanced practitioner working in acute care at Lancashire Teaching Hospitals NHS Trust.
