Author: Mansfield, Lyndon E.

Source: Allergy and Asthma Proceedings, Volume 29, Number 2, March-April 2008 , pp. 103-108(6)

Publisher: OceanSide Publications, Inc

Abstract:

The combination of long-acting beta-agonist (LABA) bronchodilators with inhaled corticosteroids (ICSs) has been shown to be an extremely effective treatment for asthma. Use of LABA as monotherapy for asthma is associated with increased adverse events including exacerbations and asthma deaths. However, intensive evaluation of the combined LABA-ICS therapy provided no signals of increased risk. LABA appears to potentiate the effects of ICS. This provides the opportunity for use a of lower ICS dose for asthma control with less risk of steroid side effects. The combination of formoterol and budesonide used as both maintenance and relief medications may offer superior asthma control with less medication use. The recent introduction of 24-hour LABA, which are in clinical trials, makes possible the concept of very effective once-daily combinations of LABA and ICS, which would be expected to increase patient adherence and improve asthma outcomes. The 24-hour LABA will likely be combined with a 24-hour anticholinergic to treat chronic obstructive pulmonary disease. Whether this dual combination with ICS will enhance our treatment of more severe asthma remains an exciting hypothesis to be tested.

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Keywords: Asthma mortality; fatal asthma; formoterol; long-acting β-agonist; patient adherence; safety; salmeterol; subsensitivity; tachyphylaxis; tolerance

Document Type: Research article

DOI: http://dx.doi.org/10.2500/aap.2008.29.3088

Affiliations: 1: Texas Tech Regional Health Science Center, El Paso, Texas; Western Sky Medical Research, El Paso, Texas

Publication date: 2008-03-01

More about this publication?

• Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.
  
  The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.
  
  Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.
  
  The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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