Advice for managing mild asthma in adults could change after a study showed combination preventer-reliever inhalers prevent more severe exacerbations than usual maintenance therapy.

In the 52-week, open-label trial, those patients asked to use combi­nation budesonide-formoterol (Symbicort) as needed had 56% fewer severe exacerbations than those asked to use twice-daily budesonide, plus salbutamol as needed.

“It’s a striking study and certainly has implications for people who don’t have a lot of symptoms,” said GP Professor Amanda Barnard, chair of the National Asthma Council guidelines committee.

However, it was not yet clear which patient populations combined therapy would be best for, she said.