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Updated: Aug 7, 2026
14:39
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Combination therapy of bronchial asthma
1National Jewish Medical and Research Center, 1400 Jackson St., Denver, CO 80206, USA.
Allergy and Asthma Proceedings
|September 13, 2001
Summary
For moderate to severe persistent asthma, combining inhaled corticosteroids with long-acting beta-agonists offers superior control compared to higher corticosteroid doses alone. This combination effectively reduces exacerbations and may positively impact airway inflammation.
Area of Science:
- Pulmonology
- Pharmacology
Background:
- National Heart Lung Blood Institute (NHLBI) guidelines suggest inhaled corticosteroids (ICS) alone or with a long-acting bronchodilator for persistent asthma.
- Three drug classes can be combined with ICS: long-acting beta-agonists (LABAs), leukotriene receptor antagonists (LRTAs), and sustained-release theophylline (SRT).
Purpose of the Study:
- To compare the efficacy of ICS combined with different bronchodilator classes against higher-dose ICS alone for asthma management.
- To evaluate the safety and effectiveness of LABA/ICS combination therapy, specifically addressing concerns about masking airway inflammation.
Main Methods:
- Review of existing clinical guidelines and comparative studies on asthma pharmacotherapy.
- Analysis of data comparing ICS/LABA, ICS/LRTA, and ICS/SRT combinations with higher-dose ICS monotherapy.
Main Results:
- All three combination therapies provide equal or better asthma control than higher-dose ICS alone.
- LABA/ICS combination therapy is the most effective among the three options.
- LABA/ICS therapy does not appear to mask airway inflammation; it reduces exacerbation frequency and severity and may modulate inflammation.
Conclusions:
- For moderate to severe persistent asthma, ICS/LABA combination therapy is a highly effective treatment option.
- Concerns regarding LABA use in combination with ICS are largely unfounded, with evidence supporting its safety and efficacy in reducing asthma exacerbations.
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