Risk of a severe exacerbation following higher reliever use: post-hoc analysis of SYGMA 1 in mild asthma

Introduction In mild asthma, as-needed budesonide/formoterol (BUD/FORM) reduces long-term severe exacerbation risk vs. terbutaline as-needed, with similar reduction as maintenance BUD + terbutaline as-needed. In a post-hoc analysis of SYGMA 1 (NCT02149199; OʼByrne et al. NEJM 2018;378(20):1865 – 1876) we examined the short-term risk of a severe exacerbation after a single day with various levels of reliever use, comparing terbutaline as-needed, BUD/FORM as-needed, and maintenance BUD + terbutaline as-needed.