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Inhaled corticosteroids plus long-acting beta2-agonists as a combined therapy in asthma
Luis García-Marcos1, Antje Schuster, Nicolás Cobos Barroso
1Department of Pediatrics, University of Murcia and Pediatric Research Unit, Dirección Salud Area II, Cartagena, Piazza San Agustín, 330201 Cartagena, Spain. lgmarcos@um.es
Expert Opinion on Pharmacotherapy
|January 9, 2003
Summary
Fixed-dose combinations of inhaled corticosteroids (ICS) and long-acting beta(2)-agonists (LABAs) offer effective asthma management. These inhalers are a safe and practical choice for patients not controlled by ICS alone.
Area of Science:
- Pulmonology
- Pharmacology
- Allergy & Immunology
Background:
- Inhaled corticosteroids (ICS) are the primary treatment for asthma.
- Combining ICS with long-acting beta(2)-agonists (LABAs) has shown efficacy comparable to doubling ICS doses in adults.
- Evidence in children remains limited.
Purpose of the Study:
- To review the efficacy and safety of combining ICS and LABAs for asthma treatment.
- To compare different administration methods and combinations.
Main Methods:
- Systematic review of clinical trials and available data on ICS/LABA combinations.
- Comparison of fixed-dose combinations versus escalating ICS doses.
- Evaluation of concurrent vs. combination inhaler administration.
Main Results:
- ICS/LABA combinations (e.g., beclomethasone/salmeterol, budesonide/formoterol) are as effective as doubling ICS doses in adults.
- ICS/LABA combinations appear more effective than adding short-acting beta(2)-agonists or antileukotrienes.
- Concurrent and combination inhaler administration show equivalent clinical efficacy.
Conclusions:
- Fixed-dose ICS/LABA combination inhalers are an effective, safe, and practical option for inadequately controlled asthma.
- Further research is needed to confirm benefits on treatment compliance and explore potential agonist effects.
- This approach is recommended for patients not achieving control with low-dose ICS alone.
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