Airsupra (budesonide/salbutamol) / AstraZeneca, Avillion - LARVOL DELTA

New data for Airsupra and Breztri highlight progress in advancing asthma and COPD care globally (AstraZeneca Press Release) - "AstraZeneca will present the latest clinical and real-world data across its leading inhaled, biologic and early science respiratory portfolio at the American Thoracic Society (ATS) International Conference, in San Francisco, CA from 16 to 21 May 2025...With more than 75 abstracts, including eight late-breakers, the Company continues to drive innovation and address unmet needs in care across all severities of asthma, chronic obstructive pulmonary disease (COPD), eosinophilic granulomatosis with polyangiitis (EGPA) and other chronic inflammatory diseases."

Clinical data • Asthma • Chronic Obstructive Pulmonary Disease • Chronic Rhinosinusitis With Nasal Polyps • Eosinophilic Granulomatosis With Polyangiitis • Inflammation

Estimating the Greenhouse Gas Emissions of Outpatient Inhalers at Stanford Medicine (ATS 2025) - "The three most prescribed inhalers were albuterol sulfate, budesonide-formoterol, and fluticasone propionate; these metered-dose inhalers alone accounted for 92% of inhaler prescriptions and 90% of inhaler-related emissions over the study period. Metered-dose inhalers accounted for the majority of inhaler prescription orders and nearly all of the inhaler-related greenhouse gas emissions from selected Stanford Medicine outpatient clinics. The carbon equivalent emissions associated with metered-dose inhaler prescriptions at these clinics were equivalent to driving an average gasoline-powered passenger vehicle for 335,218 miles. While the increased use of propellant-free dry powder and soft mist inhalers may reduce the carbon footprint of respiratory care, individual prescribing decisions must be weighed against clinical and cost considerations."

Clinical • Immunology

Efficacy of As-needed Albuterol‒Budesonide Versus Albuterol on Systemic Corticosteroid Exposure in Participants With Mild Asthma: BATURA Prespecified Analysis (ATS 2025) - P3 | "Here, we report the difference in total SCS exposure between treatment groups in prednisone equivalents. Total SCS exposure for the overall population was 2.7-fold greater in the ALB group compared to the ALB-BUD group (Figure). Conclusions In participants with mild asthma in the BATURA trial, rescue therapy with as-needed ALB-BUD reduced the total SCS exposure compared with ALB, reducing known risks from cumulative exposure to SCS."

Clinical • Asthma • Immunology • Respiratory Diseases

Can a New Portable Valved Holding Chamber (VHC) for Use on the Go Improve the Delivery and Reduce Side Effects of a New Combination Albuterol/Budesonide Inhaler? (ATS 2025) - "This study showed that the AeroChamber2go[asterisk] and AeroChamber Plus[asterisk] Flow-Vu[asterisk] VHCs provided similar FPM, compared to the MDI alone. Additionally, the VHCs reduced the CPM associated with oropharyngeal deposition, which could be particularly important with inhaled corticosteroids like budesonide. If deposited in the oropharyngeal region, absorption into the bloodstream increases the potential for systemic side effects."

Adverse events • Asthma • Immunology • Respiratory Diseases

Baseline Characteristics of Patients With Asthma Initiating Albuterol-Budesonide Rescue: A Real-world US Claims-based Study (ATS 2025) - "Conclusions Among early adopters of albuterol−budesonide as a rescue therapy in the United States, patients commonly presented with substantial comorbidities and a high clinical burden. The treatment has been initiated across the spectrum of asthma severity and control levels, as established with previous clinical evidence."

Clinical • Real-world • Real-world evidence • Allergic Rhinitis • Asthma • Chronic Obstructive Pulmonary Disease • Immunology • Inflammation • Pulmonary Disease • Respiratory Diseases

Corticosteroid-associated Systemic Adverse Events in Patients on Background Inhaled Corticosteroid Maintenance Therapy and Taking Albuterol-Budesonide Versus Albuterol as Rescue: Post-hoc Analysis of MANDALA (ATS 2025) - P3 | "As-needed albuterol-budesonide 180/160 μg had a systemic AE profile similar to that of albuterol 180 μg, with SCS-associated AEs generally low in both treatment groups, irrespective of background maintenance ICS dose."

Adverse events • Clinical • Retrospective data • Asthma • Cardiovascular • CNS Disorders • Immunology • Musculoskeletal Diseases • Nephrology • Orthopedics • Renal Disease • Respiratory Diseases • Vascular Neurology

Albuterol-Budesonide Treatment in Acute Airway Obstruction: Patient Selection for the ALTA Study (ATS 2025) - P3 | "The baseline characteristics of patients in the ALTA study reveal that patients treated as intermittent asthma exhibit heterogeneity in clinical characteristics, airway hyper-reactivity, T2 inflammation, and disease severity and control. Additional genomic and biomarker data are forthcoming and altogether will provide an opportunity to address the mechanism of albuterol and budesonide interactions in a broad spectrum of asthma phenotypes."

Clinical • Asthma • Immunology • Inflammation • Pulmonary Disease • Respiratory Diseases

Airway Inflammation and Asthma Control in Patients With Moderate Asthma Using Salbutamol or Budesonide/Formoterol Reliever: A Randomized, Controlled, Open-label Study (ATS 2025) - P4 | "BUD/FORM AIR reduced the variability of FeNO, an airway inflammation marker, and the number of acute events compared with salbutamol reliever, which is consistent with its mechanism of action as an anti-inflammatory reliever. Further studies are needed to establish patterns around acute exacerbation events."

Clinical • Asthma • Immunology • Inflammation • Respiratory Diseases

As-needed Albuterol-budesonide Decreases Risk of Severe Asthma Exacerbation in the First Three Months Post-randomization Compared to As-needed Albuterol in Patients Treated for Moderate-to-Severe Asthma: MANDALA Post-Hoc Analysis (ATS 2025) - P3 | "Conclusions In patients aged ≥12 years with moderate-to-severe asthma, on as-needed albuterol−budesonide 180/160 µg versus albuterol 180 µg, severe exacerbation risk and annualized exacerbation rates were significantly decreased already in the first 3 months, similar to those seen long-term, indicating a rapid protective effect of the albuterol−budesonide combination. Clinicians and patients switching from albuterol to albuterol−budesonide rescue can anticipate reduction in severe exacerbation risk within 3 months of albuterol−budesonide initiation, which is sustained long-term."

Clinical • Retrospective data • Asthma • Immunology • Respiratory Diseases

Calcium-channel Blocker Induced Respiratory Failure? An Unusual Phenomenon (ATS 2025) - "Home medications included Albuterol, Budesonide-Glycopyr-Formoterol, Diltiazem ER 360 mg daily, Lisinopril, Metoprolol, Ranolazine, Tamsulosin, and Torsemide.Examination revealed coarse rhonchi in the left lung and pitting edema...CT angiography chest imaging revealed mass-like consolidation in the left lower lobe, tracheobronchomalacia, and no pulmonary embolism.The patient was admitted to the medical intensive care unit (MICU) for agitation, started on a Dexmedetomidine drip, and received antibiotics for pneumonia...However, blocking HPV can exacerbate V/Q mismatch and lead to significant hypoxemia. This case underscores the need for clinicians to consider the potential adverse effects of vasodilators like Diltiazem in patients with acute pulmonary illnesses."

Atrial Fibrillation • Cardiovascular • Chronic Obstructive Pulmonary Disease • Congestive Heart Failure • Coronary Artery Disease • Diabetes • Heart Failure • Hypertension • Immunology • Infectious Disease • Metabolic Disorders • Obstructive Sleep Apnea • Pain • Pneumonia • Pulmonary Arterial Hypertension • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases • Sleep Disorder • Type 2 Diabetes Mellitus

AIRSA001: Anti-Inflammatory Reliever South Africa (clinicaltrials.gov) - P3 | N=1038 | Enrolling by invitation | Sponsor: University of KwaZulu | Not yet recruiting ➔ Enrolling by invitation

Enrollment open • Asthma • Immunology • Pulmonary Disease • Respiratory Diseases

Effects on Morning Trough Lung Function with Four Times Daily Use of Albuterol-Budesonide Versus Albuterol Over 1 Weeks' Time: Results from the DENALI Study (AAAAI-WAO 2025) - "Conclusions Four times daily albuterol-budesonide versus albuterol over 1 week resulted in significantly improved morning trough lung function; albuterol or budesonide alone did not differ from placebo. These observations are relevant for the time surrounding exacerbations when frequent rescue use occurs."

Asthma • Immunology • Respiratory Diseases

Efficacy Of As-needed Albuterol‒Budesonide Versus Albuterol By Baseline Therapy In Participants With Mild Asthma: BATURA Pre-specified Analysis (AAAAI-WAO 2025) - P3 | "Similarly, ALB-BUD reduced annualized severe exacerbation rate, versus ALB, in the SABA-alone (rate ratio [RR] 0.38, 95% CI 0.26, 0.56) and SABA+maintenance subgroups (RR 0.77, 95% CI 0.43, 1.38). Conclusions In participants with mild asthma in BATURA, ALB-BUD significantly reduced the risk of a severe exacerbation in those receiving SABA-alone and showed a trend in risk reduction in those on maintenance therapy."

Clinical • Late-breaking abstract • Asthma • Immunology • Respiratory Diseases

PT027 Compared to PT007 in Patients With Asthma With Mannitol-induced Acute Airway Obstruction (clinicaltrials.gov) - P3 | N=21 | Completed | Sponsor: AstraZeneca | Recruiting ➔ Completed | N=105 ➔ 21

Enrollment change • Trial completion • Asthma • Immunology • Pulmonary Disease • Respiratory Diseases

Severe pneumonia caused by Elizabethkingia anophelis combined with Acinetobacter baumannii infection: a case report. (PubMed, Am J Transl Res) - "He was discharged from the hospital after being given cefoperazone sulbactam sodium and minocycline, as well as nebulized inhalation of chymotrypsin, salbutamol, and budesonide to assist ventilation. This article summarizes the diagnosis and treatment of this patient in order to share the experience of the subsequent treatments."

Journal • Infectious Disease • Novel Coronavirus Disease • Pneumonia • Respiratory Diseases

ARRIVAL: Open-label Study to Assess Reduction of Background Asthma Medication While Sustaining Asthma Control and Clinical Remission With Tezepelumab in Patients 12-80yrs With Severe Asthma. (clinicaltrials.gov) - P3 | N=300 | Recruiting | Sponsor: AstraZeneca | Not yet recruiting ➔ Recruiting

Enrollment open • Asthma • Immunology • Pulmonary Disease • Respiratory Diseases

Distinguished Industry & Late-breaking Oral Abstracts - Session 2 (ACAAI 2024) - "Learning Objectives Objective 1: Observe that dupilumab reduced severe exacerbations in children with moderate-to-severe type 2 asthma, irrespective of evidence of allergic asthma for up to 104 weeks...Discuss achievement of stringent itch reduction targets with tapinarof cream 1% once daily compared with vehicle cream in two phase 3 trials in adults and children with atopic dermatitis...Describe the impact of treatment with roflumilast cream 0.15% in patients with mild or moderate atopic dermatitis, including changes in the disease's impact on family and caregivers. Objective 3: Compare the effects of as-needed albuterol–budesonide 180/160 µg vs albuterol 180 µg on severe asthma exacerbation risk and safety in patients aged =12 years with mild asthma. Consider nirsevimab for the prevention of RSV lower respiratory tract disease in both inpatient and outpatient settings. Upon completion of this session, clinicians should be able to proficiently communicate..."

Late-breaking abstract • Asthma • Atopic Dermatitis • Chronic Rhinosinusitis With Nasal Polyps • Dermatitis • Dermatology • Immunology • Respiratory Diseases • Respiratory Syncytial Virus Infections

BATURA: A Fully Virtual Randomized Controlled Study of As-Needed Albuterol-Budesonide versus Albuterol in Mild Asthma (ACAAI 2024) - P3 | "The BATURA study enrolled 2421 participants (1209 randomized to ALB-BUD and 1212 to ALB); the mean (SD) age was 42.7 (14.50) years; 2.8% were 12 to 17 years old and 68.3% female. Compared with ALB, ALB-BUD reduced severe exacerbation risk by 47% in a time-to-first-severe-exacerbation analysis (hazard ratio = 0.535, 95% CI: 0.392-0.730, P < .001). Similar percentages of participants experienced adverse events in both groups (Table 1)."

Clinical • Late-breaking abstract • Asthma • Immunology • Respiratory Diseases

EFFECTS OF AS-NEEDED ALBUTEROLBUDESONIDE VERSUS ALBUTEROL ON ASTHMA EXACERBATIONS AND LUNG FUNCTION BY BASELINE OBSTRUCTION (ACAAI 2024) - P3 | "As-needed albuterol-budesonide vs albuterol reduced severe exacerbation risk and improved lung function for patients with moderate-to-severe asthma, including those with baseline postbronchodilator airflow obstruction. 1A. Time to first severe exacerbation by baseline post-bronchodilator FEV1/FVC."

Asthma • Immunology • Respiratory Diseases

PATTERNS OF AS-NEEDED USE OF ALBUTEROL-BUDESONIDE OR ALBUTEROL AROUND A SEVERE EXACERBATION: MANDALA POST-HOC ANALYSIS (ACAAI 2024) - P3 | "In MANDALA, patients receiving albuterol-budesonide rescue tended to use fewer as-needed inhalations in the 15 days before and after a severe exacerbation than those receiving albuterol Daily as-needed study medication use for 15 days before and after the first day of the first severe asthma exacerbation (Day 0), and in non-exacerbating patients"

Retrospective data • Asthma • Immunology • Respiratory Diseases

INPATIENT USE OF BENRALIZUMAB IN ACUTE SEVERE EOSINOPHILIC ASTHMA (CHEST 2024) - "Because T2 inflammation involves cytokines such as IL-4, 5, and 13, biologics like pascolizumab, benralizumab, and lebrikizumab respectively have been used as corticosteroid-sparing therapeutics [1]...Four months later, despite compliance with his inhaler regimen, he presented to the emergency department with worsening shortness of breath shortly after treatment with a one-time injection of triamcinolone and as-needed salbutamol-budesonide by his primary care physician... Uncontrolled eosinophilic asthma can be a challenging entity to manage leading to prolonged hospital stays and high corticosteroid burden. Here, we highlight how benralizumab was used to treat an acute exacerbation in an effective and timely manner thus warranting further study."

Clinical • Asthma • Cardiovascular • Cough • Eosinophilia • Hypertension • Immunology • Infectious Disease • Inflammation • Novel Coronavirus Disease • Pulmonary Disease • Respiratory Diseases • IL4

DARWIN: Study to Investigate Changes in Airway Inflammation, Symptoms, and Rescue Therapy Utilization With AIRSUPRA Compared to Albuterol as Needed in Adults With Mild Asthma (clinicaltrials.gov) - P4 | N=100 | Recruiting | Sponsor: AstraZeneca | Not yet recruiting ➔ Recruiting

Enrollment open • Asthma • Immunology • Inflammation • Pulmonary Disease • Respiratory Diseases

LESSONS FROM BENCH TO BEDSIDE: EXPLORING GENOMIC AND NONGENOMIC MECHANISMS OF ALBUTEROL-BUDESONIDE AS NEEDED FOR TREATMENT AND PREVENTION OF ACUTE AIRWAY OBSTRUCTION (ALTA) (CHEST 2024) - P3 | "While there is in vitro understanding of the mechanisms by which a fast-acting beta2-agonist and ICS may interact to effect bronchoconstriction and airway inflammation, ALTA is the first study to explore potential in vivo inflammatory and genomic mechanisms of SABA-ICS in the treatment and prevention of acute airway obstruction on lung function, symptoms, airway hyperresponsiveness, and airway inflammation. CLINICAL IMPLICATIONS: ALTA will provide patient-based, mechanistic data across asthma endotypes that will inform decisions by practicing clinicians to use combination rescue therapy."

Asthma • Immunology • Inflammation • Respiratory Diseases

INSIGHTS INTO SURFACTANT PROTEIN C DEFICIENCY: A CASE STUDY OF AN INFANT WITH THE C.565T>G (P.CYS189GLY) MUTATION (CHEST 2024) - "Budesonide, albuterol, and hypertonic saline treatments were prescribed prior to discharge...The patient was treated with steroids and azithromycin for anti-inflammatory effect prior to obtaining open lung biopsy...Current clinical considerations are long-term treatment with steroids and/or hydroxychloroquine... While c.565T>G (p.Cys189Gly) is reported as a variant of uncertain significance, our patient has clinical and pathological findings consistent with a surfactant protein deficiency leading us to conclude that this variant likely has clinical significance."

Case study • Clinical • Surfactant • Acute Respiratory Distress Syndrome • Fibrosis • Immunology • Inflammation • Interstitial Lung Disease • Pulmonary Disease • Respiratory Diseases • SFTPC

ACHALASIA: UNUSUAL CAUSE OF COUGH IN CHILDREN (CHEST 2024) - "He was also started on inhaled albuterol and budesonide medications with no response... Early diagnosis and surgical oesophagomyotomy leads to a successful outcome."

Clinical • Chronic Cough • Cough • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Infectious Disease • Pain • Rare Diseases • Respiratory Diseases