The Debate About the Use of Long-Acting Inhaled β2-agonists in Asthma

Long-acting inhaled β2-agonists (LABAs) have been available for the treatment of asthma for almost 30 years; there is, however, concern about their safety with regular use. There is widespread agreement that LABA should not be used as monotherapy by asthmatic patients, because, while they are very effective in providing symptom relief, they have no inherent anti-inflammatory properties, and may increase the risk of asthma mortality. When used together with inhaled corticosteroids (ICS), ideally in the same inhaler, ICS/ LABA combinations have been shown to improve asthma control and reduce risk of asthma exacerbations. Concerns about the risks of severe asthma related events, such as hospitalization, intubation or death, associated with the use of ICS/LABA combinations have been allayed by the results of several recent large randomized safety trials conducted both in adults and children.