Shivanthan Shanthikumar
The Royal Children's Hospital, Melbourne, Australia
For over 30 years the cornerstone of asthma management has been the use of short acting beta agonist (SABA) therapy to relieve asthma symtpoms. However, there have been several issues with this approach with SABA overuse being associated with increased severe asthma exacerbations and increased mortality.
In 2019, in response to a series of seminal randomised controlled trials, the Global Initiative for Asthma (GINA) made a paradigm-shifting change to recommend anti-inflammatory reliever (AIR) therapy as the preferred reliever for all people 12 years and older.
AIR can be used as AIR-alone (for mild asthma, with no maintenance therapy), or as part of Maintenance and Reliever Therapy (MART, for moderate to severe asthma). AIR-based therapy is associated with reduced severe asthma exacerbations in adolescents and adults, when compared to traditional SABA based regimes.
Several issues remain however, especially regarding the lack of evidence in children 11 years and younger.
This talk will discuss the rationale, evidence base, gaps in evidence and path ahead for AIR therapy in childhood asthma.