2024 marked a pivotal change in the management of asthma in the UK with the publication of a joint British Thoracic Society (BTS), National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) guideline. This guideline, ‘Asthma: diagnosis, monitoring and chronic asthma management’, has the potential to be the paradigm shift that is needed to improve asthma care in the UK.

In the 2024 BTS/NICE/SIGN guideline1 there is a clear statement that says:

“Do not prescribe short-acting beta-agonists to people of any age with asthma without a concomitant prescription for ICS”

For adults and adolescents aged 12 and over the guidelines now recommend one pathway which is similar to GINA track 1 and recommends a low-dose ICS/formoterol combination
inhaler to be taken as needed (AIR therapy) as the first step or low-dose ICS/formoterol as MART for those who are highly symptomatic or exacerbating at presentation. There is no alternative treatment pathway recommended for this age group and therefore no recommendation for treatment regimens using SABA as a rescue/reliever inhaler. The guideline committee highlighted that this decision was due to the clear evidence for exacerbation reduction using strategies where ICS/formoterol is the reliever/rescue inhaler.

This article outlines PCRS position on the use of rescue/reliever inhalers to manage asthma symptoms. It supports the pharmacological asthma management approaches recommended in the 2024 ‘Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN)’.