Inhaled steroids in asthma. Should the doses be reduced?

Since their introduction in the 1970s, unit doses of inhaled corticosteroids (ICS) have increased exponentially (a twenty-fold rise from beclomethasone 50 micrograms through fluticasone 500 micrograms). Current prescription data suggests that in Australia more than 50% of all dispensed fluticasone/salmeterol dry powder units are the 500/50 micrograms combination.

To discuss the efficiency of doses currently used in Australia.

The use of both single drug ICS therapy alone or in conjunction with a long acting beta agonist (LABA) may be too high. The additional therapeutic effects of such doses are likely to be of minimal benefit (if any at all) and expose patients to unnecessary long term side effects.