A PCORI-funded study found that Black and Latino people with moderate to severe asthma benefited from adding controller medicine to their quick-relief medicine.
More than 25 million people in the United States have asthma. Black and Latino people have higher rates of asthma and complications than other groups and also die from asthma at least twice as often as White people.
Asthma can range from mild to severe, depending on how often symptoms occur. People with moderate to severe asthma have symptoms every day or several times a day. They may have symptoms less often if their asthma is managed well.
To manage asthma on a daily basis, people take a medicine called inhaled corticosteroid, or ICS, once a day. ICS is a controller medicine, which helps with long-term control of asthma. People take controller medicine in an inhaler, a small handheld device that pushes medicine into the lungs. Brand names for controller medicines include Pulmicort®, Qvar®, and Asmanex®.
Findings
A PCORI-funded study found that adding a dose of controller medicine to a quick-relief medicine:
- Lowered the rate of severe asthma attacks among Black and Latino adults with moderate to severe asthma
- Improved asthma control and quality of life
- Lowered the number of days missed from work or school
- Lowered the number of missed activities
Sometimes people with asthma have an asthma attack. During an attack, the small muscles surrounding the airways in the lung become inflamed and tighten. Asthma attacks make it hard to breathe. People may have tightness in their chest, coughing, or wheezing, which is a whistling sound while breathing. When people have an asthma attack, they take a quick-relief medicine through an inhaler or nebulizer. A quick-relief medicine is also called a rescue medicine. Brand names for quick-relief medicines include ProAir®, Ventolin®, and Xopoenex®.
In this study, people took their controller medicine whenever they took their quick-relief medicine for an asthma attack. People in the study could use an inhaler or a nebulizer for their quick-relief medicine. Every person in the study also took their controller medicine once each day, whether they had asthma symptoms or not. This approach is known as PARTICS, or Patient-Activated Reliever-Triggered Inhaled Corticosteroid.
Study participants were Black and Latino people. The study team wanted to learn if participants would have fewer attacks if they added their controller medicine along with their quick-relief medicine when they had asthma attacks. Other studies have shown that taking a dose of controller medicine along with quick-relief medicine during an asthma attack leads to better asthma control and fewer attacks. But these studies did not include many Black or Latino people. These studies also did not include people who used nebulizers for quick relief.
Questions to Ask Your Clinician
If you and your clinician, like your doctor or nurse practitioner, decide it is best for you to take a controller medicine whenever you take your quick-relief medicine, your clinician can help you adjust your Asthma Action Plan. Questions to ask your clinician may include:
➤ Does my current treatment plan include the use of a controller medicine when I take quick-relief medicine?
➤ Will adding controller medicine whenever I take my quick-relief medicine help control my asthma?
➤ Which daily controller medicine and quick-relief medicines should I use to treat my asthma?
➤ How much controller medicine do I add if I’m using an inhaler for quick relief? What if I’m using a nebulizer for quick relief?
➤ How can I tell if taking controller medicine when I take my quick-relief medicine is helping my asthma?
➤ Is there anything else I need to be concerned about when using my controller medicine with my quick-relief medicine?
About the Study
In this study, the research team enrolled 1,201 Black and Latino adults with moderate to severe asthma. The team assigned people by chance to one of two groups. One group followed their usual asthma care. The other group received instructions to use PARTICS. With PARTICS, people added one puff of controller medicine each time they used a quick-relief inhaler or five puffs of controller medicine each time they used a nebulizer. The team looked at patients’ health outcomes after 15 months.
Read more about this study at www.pcori.org/Israel494
PCORI produced this Evidence Update in collaboration with the Allergy & Asthma Network.
SOURCES
© 2011–2025 Patient-Centered Outcomes Research Institute. “Comparing Ways to Decrease Severe Asthma Attacks among Black and Latinx Adults with Moderate to Severe Asthma -- The PREPARE Study.” Updated October 18, 2024. https://www.pcori.org/Israel494
Israel E, Cardet JC, Carroll JK, et al. Reliever-triggered inhaled glucocorticoid in Black and Latinx adults with asthma. N Engl J Med. 2022;386(16):1505-1518. https://doi.org/10.1056/NEJMoa2118813
The information in this publication is not intended to be a substitute for professional medical advice. This update summarizes findings from a PCORI research award to Partners Healthcare Brigham and Women’s Hospital.
Posted: Feb. 28, 2025