From the Guidelines
Asthma treatment should prioritize daily controller medications such as inhaled corticosteroids (ICSs) to reduce airway inflammation, with the addition of long-acting bronchodilators (LABAs) for moderate to severe cases, as recommended by the most recent guidelines 1.
Treatment Overview
Asthma management involves a combination of medications and lifestyle changes to control symptoms and prevent attacks. The primary medications include:
- Quick-relief bronchodilators like albuterol (2 puffs every 4-6 hours as needed) for immediate symptom relief
- Daily controller medications such as ICSs (like fluticasone or budesonide, typically 1-2 puffs twice daily) to reduce airway inflammation
Controller Medications
For moderate to severe asthma, combination inhalers containing both a corticosteroid and a LABA (like fluticasone/salmeterol or budesonide/formoterol) may be prescribed, as they have been shown to be effective in reducing symptoms and preventing exacerbations 1. Some patients also benefit from:
- Leukotriene modifiers (montelukast 10mg daily)
- Biologics (such as omalizumab) for severe cases, particularly those with IgE-mediated allergic asthma 1
Proper Inhaler Technique and Asthma Action Plan
Proper inhaler technique is crucial, with patients instructed to:
- Inhale slowly and deeply
- Hold their breath for 10 seconds
- Use spacer devices when appropriate Creating an asthma action plan with a healthcare provider helps manage symptoms effectively, detailing when to adjust medications based on symptom severity.
Trigger Avoidance
Identifying and avoiding triggers such as allergens, smoke, and certain medications is essential to prevent asthma symptoms and maintain normal breathing. These treatments work by reducing airway inflammation, relaxing airway muscles, and preventing the immune responses that cause asthma symptoms, allowing patients to maintain normal breathing and prevent long-term airway damage 1.
From the FDA Drug Label
Wixela Inhub® is a combination product containing a corticosteroid and a long-acting beta2-adrenergic agonist (LABA) indicated for: • Twice-daily treatment of asthma in patients aged 4 years and older. (1.1)
For oral inhalation only. (2) • Treatment of asthma in patients aged 12 years and older: 1 inhalation of Wixela Inhub® 100/50, Wixela Inhub® 250/50, or Wixela Inhub® 500/50 twice daily. Starting dosage is based on asthma severity. (2. 1) • Treatment of asthma in patients aged 4 to 11 years: 1 inhalation of Wixela Inhub® 100/50 twice daily. (2.1)
The treatment for asthma using Wixela Inhub is twice-daily inhalation of the medication, with the specific dosage depending on the age of the patient and asthma severity.
- For patients 12 years and older, the dosage is 1 inhalation of Wixela Inhub 100/50,250/50, or 500/50 twice daily.
- For patients 4 to 11 years, the dosage is 1 inhalation of Wixela Inhub 100/50 twice daily 2.
From the Research
Treatment Options for Asthma
- Inhaled corticosteroids are the most effective class of controller medication available today for treating persistent asthma and are the evidence-based guideline-recommended first-line treatment for controlling asthma 3.
- Long-acting inhaled beta(2)-agonists (LABAs) are also recommended treatment options for asthma, and can be used in combination with inhaled corticosteroids for improved symptom control 4.
- Single-inhaler combination therapy, such as salmeterol/fluticasone propionate or budesonide/formoterol, can be used for both maintenance and relief of asthma symptoms, and has been shown to be effective in reducing exacerbations and improving symptom control 5.
Guidelines for Asthma Management
- The 2019 Global Initiative for Asthma (GINA) guidelines recommend that all asthma patients be treated with inhaled corticosteroids taken daily or as needed, and that treatment be escalated or de-escalated based on symptom control 6.
- A stepwise approach to asthma management is recommended, with treatment intensity adjusted based on symptom severity and control 6.
Comparison of Treatment Outcomes
- Studies have compared the effectiveness of different inhaled corticosteroids and LABAs, such as fluticasone and formoterol, and have found that these medications can provide improved therapeutic benefits compared to other options 4, 7.
- Real-world data have shown that treatment with fluticasone furoate/vilanterol can reduce the risk of severe asthma exacerbations and improve lung function and symptom control in patients with asthma, compared to treatment with budesonide/formoterol 7.