Ep. 117: As-Needed Albuterol–Budesonide in Mild Asthma (BATURA Trial)
Part of the series: The Itch Review
LISTEN TO EPISODE 117: Apple Podcast • Spotify • Amazon Music
This podcast was made in partnership with Allergy & Asthma Network.
We thank AstraZeneca for sponsoring this episode. While they support the show, all opinions are our own, and sponsorship doesn’t influence our content or editorial decisions. Any mention of brands is for informational purposes and not an endorsement.
There have been countless advances in controller therapies for asthma, but our go-to rescue inhaler, a quick-relief bronchodilator, hasn’t changed in decades.
In this episode of The Itch Review, we spotlight “As-Needed Albuterol–Budesonide in Mild Asthma” published in The New England Journal of Medicine, May 19, 2025. This article looks at the BATURA trial, which tested whether adding budesonide to albuterol rescue inhalers cuts exacerbations in adults whose mild asthma remains uncontrolled on occasional albuterol/short-acting beta agonist (SABA) therapy.
Could this combo inhaler really cut severe asthma attacks in people with mild disease?
What we cover in our episode about the BATURA trial:
Understanding asthma: In asthma, your airways both tighten up and get swollen. Treating both the tightness and the swelling right when you feel symptoms could stop a full-blown attack.
All-online trial: BATURA used telehealth to enroll 2,516 people with mild asthma from across the U.S. and ran the study until it saw a preset number of 172 serious attacks.
Big takeaways: The combo inhaler cut serious attacks by almost half, halved yearly flare-ups, and slashed steroid use by 63%. All without people needing to use their medication more often.
Why it ended early: An independent safety board reviewed the data mid-trial and concluded that the combo inhaler was so clearly better that it would’ve been unfair to continue giving anyone the old treatment.
What’s next: We still need studies on teens and children to ensure that these same benefits hold true for younger patients.
The Itch Review - BATURA Trial Infographic
Listen now! Apple Podcast • Spotify • Amazon Music
More resources about asthma
More episodes about asthma
The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores the latest allergy and immunology studies, breaking down complex research in conversations accessible to clinicians, patients, and caregivers. Each episode provides key insights from journal articles and includes a one-page infographic in the show notes for easy reference.
Timestamps
Our episode reviews whether adding a steroid to rescue inhaler will lower flares
01:40 Different types of asthma inhalers and how they work
04:27 Introduction to the “smart” inhaler concept
07:22 The goals and questions driving the BATURA trial
08:03 What qualifies as mild asthma today
10:45 Key features of BATURA’s fully virtual, event-driven design
13:46 Who enrolled: participant criteria and demographics
19:06 Why researchers targeted uncontrolled mild asthmatics
19:41 Primary and secondary outcomes under review
21:13 Explaining the intention-to-treat analysis
23:50 Main findings from the BATURA trial
28:01 Insights from secondary endpoint results
30:44 Safety and tolerability of the combo inhaler
33:11 Major strengths of the BATURA study design
35:07 Key limitations and considerations
36:34 Dr. Blaiss’s clinical takeaways
37:21 Dr. Gupta’s expert insights
