A New Relief Inhaler for Mild Asthma

  • Research type

    Research Study

  • Full title

    Randomised controlled trial of a new relief inhaler in mild asthma: the RELIEF trial

  • IRAS ID

    1006098

  • Contact name

    Timothy Harrison

  • Contact email

    tim.harrison@nottingham.ac.uk

  • Sponsor organisation

    University of Nottingham

  • ISRCTN Number

    ISRCTN29579666

  • Research summary

    Approximately 10% of UK adults have asthma. Many have “mild” asthma, requiring reliever (blue) inhalers for symptoms with or without, low-dose-inhaled steroid (preventer) treatment. Asthma causes airway inflammation, so treatment with regular inhaled steroids is important. Blue inhalers provide symptom relief but do not help inflammation. Increasing blue inhaler use & decreasing use of preventer inhalers is associated with poorer asthma outcomes.
    The Global Initiative for Asthma (world-wide asthma recommendations) took a bold and controversial step of replacing the first-choice standard blue inhaler for all asthma patients, recommending a combination inhaler containing both reliever and a preventer medication. Patients get preventer medication every time they use their reliever reducing the problem of low preventer use, providing more when asthma control is getting worse. We know combination inhalers are better for moderated/severe symptom relief and outcomes, and see some benefit in “mild” asthma, but more evidence is required. This study will compare “standard care” treatment for “mild asthma” versus “new combined inhaler” + ICS treatment.
    The study aims to determine;
    • Effectiveness of a combination inhaler versus standard care for symptom relief in mild asthma
    • Overall costs and savings of the two approaches
    • Health care providers and patients perspectives of the new approach
    Study to include 2300 volunteers from primary-care centres, with mild asthma, across the UK, with particular focus on areas where blue inhaler overuse and asthma attacks are higher. Patients will be selected at random to be in either one of two groups for the study. Asthma exacerbations is the primary outcome.
    Patients will be in the study for 12 months, completing questionnaires about asthma and health resource use at several time-points. A proportion will also be interviewed.
    Patients with asthma have helped throughout with planning and a patient co-applicant will join TMG.

  • REC name

    HSC REC B

  • REC reference

    22/NI/0151

  • Date of REC Opinion

    3 Mar 2023

  • REC opinion

    Further Information Favourable Opinion