From the Guidelines
Reactive airway disease should be managed with short-acting bronchodilators like albuterol (2 puffs every 4-6 hours as needed) to relieve acute symptoms, and inhaled corticosteroids such as fluticasone (110-220 mcg twice daily) or budesonide (180-360 mcg twice daily) for 2-4 weeks to reduce inflammation in patients with persistent symptoms. This approach is supported by the principles outlined in the management of asthma, which shares similar symptoms and pathophysiology with reactive airway disease 1. The key to managing reactive airway disease involves:
- Identifying and controlling environmental triggers
- Patient education for day-to-day management
- Monitoring of pulmonary function
- Pharmacological treatment based on the severity of symptoms
In terms of pharmacological treatment, the use of short-acting inhaled beta-agonist more than 2 times a week may indicate the need to initiate or increase long-term control therapy 1. It's essential to note that reactive airway disease is a temporary condition, often following a respiratory infection, and differs from asthma, which is a chronic condition. However, some patients with reactive airway disease may eventually be diagnosed with asthma if symptoms persist beyond 6-8 weeks. Patients should seek immediate medical attention if experiencing severe shortness of breath, inability to speak in complete sentences, or if symptoms don't improve with medication.
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) • Maintenance treatment of airflow obstruction and reducing exacerbations in patients with chronic obstructive pulmonary disease (COPD). (1. 2)
The drug label indicates that salmeterol (INH) is used for the treatment of asthma and COPD, which are both related to reactive airway disease.
- Asthma is a type of reactive airway disease.
- The label does not explicitly state that salmeterol (INH) is used to treat reactive airway disease, but it does mention asthma, which is a related condition. However, based on the information provided, it can be inferred that salmeterol (INH) may be used in the context of reactive airway disease, specifically for the treatment of asthma 2.
From the Research
Definition and Treatment of Reactive Airway Disease
- Reactive airway disease, also known as asthma, is a chronic inflammatory disease of the airways characterized by recurring episodes of wheezing, coughing, chest tightness, and shortness of breath 3.
- The treatment of reactive airway disease typically involves the use of inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA) to control symptoms and prevent exacerbations 3, 4.
Effects of ICS and LABA on Reactive Airway Disease
- ICS therapy has been shown to improve asthma control, lung function, and prevent exacerbations of disease, while LABA therapy can increase the efficacy of ICS effects in moderate-to-severe asthma 3.
- The combination of ICS and LABA has been found to be more effective than ICS alone in improving lung function and reducing exacerbations in patients with chronic obstructive pulmonary disease (COPD) 5, 6.
- However, the use of ICS has also been associated with an increased risk of pneumonia, particularly in patients with COPD 5, 6.
Comparison of ICS and LABA in Reactive Airway Disease
- Studies have compared the effects of ICS and LABA on reactive airway disease, with some finding that ICS is more effective in reducing exacerbations and improving quality of life, while LABA is more effective in improving lung function 5, 6.
- However, other studies have found that the combination of ICS and LABA is more effective than either therapy alone in reducing exacerbations and improving lung function 3, 4.
As-Needed Use of ICS and LABA in Mild Asthma
- A recent study found that as-needed use of albuterol-budesonide resulted in a lower risk of severe asthma exacerbation than as-needed use of albuterol alone in patients with mild asthma 7.
- This study suggests that the use of ICS and LABA in combination may be beneficial even in patients with mild asthma, although further research is needed to confirm these findings.