The National Asthma Council Australia (NAC) has released major updates to the Australian Asthma Handbook, advising health professionals to stop prescribing short-acting beta2 agonists (SABA) alone for asthma management in adults and adolescents.
Launched today (16 September) by the Minister for Health and Ageing, the Hon. Mark Butler, the revised national guidelines recommend that adults and adolescents (aged 12 and over) be prescribed anti-inflammatory reliever (AIR) therapy and maintenance-and-reliever therapy (MART).
‘SABA-only treatment associated with higher exacerbation risk’
Clinical Associate Professor Debbie Rigby, a pharmacist and Clinical Executive Lead at NAC, states that inhaled corticosteroids (ICS) are now indicated for all adults and adolescents with asthma.
“The updated NAC Australian Asthma Handbook guidelines released today state that all adults and adolescents with asthma need ICS as part of their treatment to reduce inflammation and prevent exacerbations.
“SABA-only treatment is associated with a higher risk of severe asthma exacerbations compared with AIR-only or with maintenance treatment with a low dose of ICS.
“For patients not using maintenance ICS-containing inhalers, low-dose budesonide-formoterol taken as needed markedly reduces the risk of severe exacerbations requiring oral corticosteroids, compared with SABA taken as needed,” she says.
‘National push to improve asthma management’
Minister Butler notes that the 2.8 million Australians living with asthma all depend on their healthcare teams to make informed decisions – guided by the latest clinical advice and practical tools – to deliver the best care and treatment possible.
“The updated Australian Asthma Handbook will support primary health professionals to better diagnose, treat and manage their patients with the condition.
“It is latest part of a national push to improve how asthma and related respiratory conditions are managed, helping those living with asthma to breathe easier and live well,” he says.
‘Prescribe anti-inflammatory treatment from day one’
Professor Nick Zwar, Chair of the NAC Guidelines Committee, says the most critical take-home message for health professionals is to prescribe anti-inflammatory treatment from day one when it comes to asthma in adults and adolescents.
“The common approach was starting patients with mild asthma on SABA as needed; however, this did not treat the underlying inflammation.
“Starting patients on the new recommendation for low-dose budesonide-formoterol as needed offers a more evidence-based approach to asthma management and reflects the biology of the condition,” he says.
Professor Zwar urges health professionals to provide every patient with a written Asthma Action Plan when prescribing AIR or MART treatment, and reinforce the importance of carrying their reliever at all times.
“This clearly outlines what the person is supposed to do and how much medication they should be using and when they should be concerned.
“If the patient takes action early and they are using a low dose anti-inflammatory medication, it means that the asthma attack is controlled more quickly and they are using less reliever medication.
“We also encourage all health professionals to advise patients to carry their anti-inflammatory reliever at all times and use it when they experience difficulty breathing, or before exercise, if needed,” he says.
‘Blue puffers no longer recommended’
Dr Anita Muñoz, Chair Victoria Faculty, RACGP and practice owner, congratulates the National Asthma Council Australia on the launch of the updated asthma guidelines and encourages all RACGP members to take time to review the new recommendations.
“Many Australians are managing their own asthma just with blue puffers that they buy over the counter at the pharmacy, but that is no longer recommended and encourages risky over-reliance,” she says.
“We encourage people with asthma to see their GP to discuss how the new recommendations may affect them and make sure they update their written asthma action plan.”
All health professionals need to review the guidelines
The launch of the updated NAC Australian Asthma Handbook and website follows extensive research and review of national and international evidence.
It was led by a multidisciplinary network of expert primary care and specialist contributors on the NAC’s Guidelines Committee.
The revised 2025 edition also includes changes for improved diagnosis and management of asthma in infants and children.
The NAC urges all health professionals to review the new Asthma Treatment Guidelines section on the updated website.
