In Reply In response to our Viewpoint encouraging the approval of safer and more effective OTC rescue inhalers for asthma, Dr May and colleagues emphasize the increased morbidity and mortality associated with β-agonist overuse in the absence of ICSs. In keeping with recent Global Initiative for Asthma guidelines, we in fact argued that as-needed ICS-FABAs should be preferred to albuterol as optimal OTC rescue therapy. The authors note the problems of albuterol without addressing the case for OTC ICS-FABAs.
