Asthma: New UK guidelines signal “step change” in diagnosis and treatment
BMJ 2024; 387 doi: https://doi.org/10.1136/bmj.q2685 (Published 29 November 2024) Cite this as: BMJ 2024;387:q2685
- Gareth Iacobucci
- The BMJ
New clinical guidelines advise doctors to stop prescribing short acting β2 agonists (SABAs) such as salbutamol on their own for new patients with asthma.
Instead, all patients aged 12 and over should be offered a low dose combination inhaler of inhaled corticosteroid (ICS) and formoterol (a long acting β2 agonist; LABA) to be taken as needed to reduce inflammation and relieve symptoms. This combination treatment is called anti-inflammatory reliever therapy.
The joint clinical guideline for the UK1—from the British Thoracic Society, the National Institute for Health and Care Excellence, and the Scottish Intercollegiate Guidelines Network—aims to bring UK practice into line with global standards.
What about people who already have asthma?
Doctors should not prescribe salbutamol “to people of any age with asthma without a concomitant prescription of an ICS,” say the guidelines.
Stephen Fowler, professor of respiratory medicine at the University of Manchester, who is a consultant respiratory physician and adult expert adviser to the 2024 joint guideline committee, told The BMJ that while a lot of people with asthma still used only a salbutamol inhaler when required, this was out of step with clinical evidence. “A blue inhaler should always be prescribed along with an inhaled steroid,” he said. If a GP is confident that a patient has asthma, he added, “they should change them to …
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