A Move Towards Preventative Treatment
Under the new guidance, people aged 12 and over who are newly diagnosed with asthma — or who require a step-up in treatment — are increasingly expected to use combination inhalers.
These inhalers combine an inhaled corticosteroid with formoterol, a long-acting beta2 agonist (LABA), in a single device. As well as providing rapid symptom relief, they also reduce inflammation and help prevent flare-ups.
Two new treatment approaches are being adopted:
- AIR (Anti-inflammatory Reliever): the inhaler is used only when symptoms occur.
- MART (Maintenance and Reliever Therapy): the inhaler is taken daily and additionally when required, typically for patients with more persistent or severe symptoms.
Use of AIR and MART inhalers has increased steadily, while reliance on SABA inhalers has declined. Although this trend began before the guideline was published, it has accelerated significantly since its introduction. For the first time, more people are now managing their asthma without relying solely on a blue inhaler.
Between October and December 2025, around 1.09 million people were using AIR or MART inhalers without any SABA inhaler — a 63% increase compared with the same period the previous year. Over the same timeframe, approximately 800,000 people used a SABA inhaler without a combination inhaler, representing a 16% decrease year-on-year.
Improved Outcomes for Patients
NICE estimates that for every 10,000 people who switch to MART inhalers, there could be:
- 1,133 fewer GP appointments each year
- 144 fewer attendances at A&E each year
- 80 fewer hospital admissions annually
Although combination inhalers are more expensive initially, they have the potential to reduce pressure on NHS services through fewer GP consultations and hospital admissions. They may also deliver wider economic benefits by reducing sickness absence from school and work.
Read the full nice news article here: more than a million people now using new style inhalers | NICE