An international clinical trial published inThe Lancethas revealed that a 2-in-1 inhaler could significantly reduceasthmaattacks in children, potentially transforming global asthma treatment guidelines. The trial-the first randomised controlled study to compare this combined therapy against standard salbutamol reliever inhalers in children aged 5 to 15-found the 2-in-1 treatment not only more effective but equally safe. Asthma remains one of the most common chronic conditions among children, and reducing the frequency of asthma attacks is a major public health priority. In this new study, researchers found that using a single inhaler combiningbudesonide, aninhaled corticosteroid(ICS), and formoterol, a fast-acting bronchodilator, reduced asthma attacks by an average of 45% compared to salbutamol, the current standard reliever medication. In the CARE study (Children’s Anti-inflammatory REliever), a total of 360 children in New Zealand were randomly assigned to receive either the combined budesonide-formoterol inhaler or a salbutamol inhaler for on-demand symptom relief. Over a one-year period, the group using the 2-in-1 inhaler experienced fewer asthma attacks, with annual rates of 0.23 attacks per child compared to 0.41 in the salbutamol group. “This is a key step in addressing the evidence gap that exists between asthma management in adults and children,” said Dr Lee Hatter, lead author and Senior Clinical Research Fellow at MRINZ. “For the first time, we have demonstrated that the budesonide-formoterol 2-in-1 inhaler, used as needed for symptom relief, can significantly reduce asthma attacks in children with mild asthma.” Importantly, the trial confirmed the safety of the combined inhaler approach, showing no significant differences in children’s growth, lung function, or overall asthma control. Although the study was conducted during the COVID-19 pandemic—when fewer respiratory viruses circulated—it was designed to reflect real-world conditions, making its findings highly applicable to clinical practice. Reference:Budesonide–formoterol versus salbutamol as reliever therapy in children with mild asthma (CARE): a 52-week, open-label, multicentre, superiority, randomised controlled trial, Hatter, LeeAnderson, Augustus J et al. The Lancet, Volume 0, Issue 0