According to a commentary on a Cochrane systematic review data, published online in Clinical & Experimental Allergy, a single combined-drug inhaler used on an as-needed basis could protect adults with mild asthma from worsening illness and hospitalization.  

The Cochrane systematic review evaluating combination fixed-dose beta-agonist and steroid inhalers for adults and children with mild asthma has been published online in BMJ Evidence-Based Medicine. It states that the data on the use of as-needed FABA/ICS [fast-acting beta2-agonist / inhaled corticosteroid] combination over as-needed FABA alone was encouraging.

The review included studies with a duration of at least 12 weeks and involved a single, fixed‐dose FABA/ICS inhaler used as needed, compared with no treatment, placebo, short‐acting beta-agonist (SABA) as required, regular ICS with SABA as required, regular fixed‐dose combination ICS/long‐acting beta-agonist (LABA), or regular fixed‐dose combination ICS/FABA with as-needed ICS/FABA. Five trials were included in the meta-analysis with 9657 participants (average age 36-43 years).

The study concluded that the combined use of as-needed FABA/ICS reduced the requirement of systemic steroids to avoid exacerbations over a 1-year period, compared to as-needed FABA alone. It reduced the chances of asthma‐related hospital admission or an emergency or urgent care visit (OR, 0.35; 95% CI, 0.20 - 0.60). The number of people with asthma exacerbations requiring systemic steroids with FABA/ICS as-needed might be similar to the number who require regular ICS (OR, 0.79; 95% CI, 0.59 - 1.07). No differences were seen in the asthma‐associated quality of life or mortality. 

Long-term medication and use by children below 12 years of age still need to be studied. (Medscape, March 11, 2022)