A New Zealand–led medical trial is being hailed as a global breakthrough, with doctors saying the findings could rewrite asthma care guidelines worldwide.
The landmark study, published in The Lancet, involved 360 children aged 5–15 across New Zealand.
It found that a single 2-in-1 inhaler, already prescribed for adults, reduced childhood asthma attacks by nearly half compared to the widely-used salbutamol treatment.
For 10-year-old Harriett Linforth-Hall, who took part in the trial, the difference was life-changing.
“The only after-school activity I ever had was swimming and I couldn’t run around usually without having to take at least three puffs of my inhaler,” she said.
“It was amazing… before I couldn’t run around as much and now, I’m running around all the time with my friends.”
Traditionally, children with asthma were given a reliever inhaler, such as salbutamol, to ease symptoms as needed, but the new approach combines both a reliever and a prevention in one device.
This meant every puff treats symptoms and helped stop future attacks, said director of the Medical Research Institute of NZ (MRINZ) and senior author of the CARE study Professor Richard Beasley,
“For every 100 children switched from salbutamol to the 2-in-1 inhaler, around 18 asthma attacks a year could be prevented.”
One concern for parents was whether the steroid component could affect children’s growth, but the study found no differences in growth, lung function, or overall asthma control between the two treatments.
Imperial College London co-author Professor Andrew Bush said the evidence should reassure families.
“People worry saying, oh goodness, there’s steroid in it. Is it going to affect my child’s growth? Well, it did not. And it is safer. It improves outcomes.”
Asthma affected an estimated 113 million children worldwide. Attacks could be frightening, disruptive, and, in severe cases, life-threatening.
Experts said the study could finally bring children’s treatment in line with adults, for whom combined inhalers have been the recommended standard for years.
“Guideline writers want to see the evidence, assess it carefully, and treat it as seriously as a judge in court,” Bush said.
“Hopefully this will now mean guidelines can be changed.”
For Harriett, the biggest reward was knowing her participation might help other kids like her.
“It’s really cool that I got to provide information to help other kids who have asthma like me.”
