Combination therapy of bronchial asthma

Allergy Asthma Proc. Jul-Aug 2001;22(4):217-20.


For treatment of moderate and severe persistent asthma the National Heart Lung Blood Institute (NHLBI) Guidelines offer the alternative of moderately high doses of inhaled corticosteroids alone or a lower dose of inhaled corticosteroids combined with a long-acting bronchodilator. Three classes of drugs qualify for the combination with inhaled corticosteroids. They are long-acting beta-agonists, leukotriene receptor antagonists, and sustained-release theophylline. Each class of drug has been shown, when combined with inhaled corticosteroids, to provide equal or better asthma control than a higher dose of inhaled corticosteroids alone. Direct comparisons indicate that, of the three classes, the long-acting beta-agonists are the most effective. Furthermore, initial concerns regarding their masking airway inflammation appear to be unfounded, because when combined with inhaled corticosteroids, the long-acting beta-agonists further decrease both the frequency and the severity of asthma exacerbations and appear to have some modulating effect on airway inflammation.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / therapeutic use*
  • Adrenergic beta-Agonists / administration & dosage
  • Adrenergic beta-Agonists / therapeutic use
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / drug therapy*
  • Bronchodilator Agents / administration & dosage
  • Bronchodilator Agents / therapeutic use*
  • Delayed-Action Preparations
  • Drug Therapy, Combination
  • Humans
  • Leukotriene Antagonists*
  • Theophylline / administration & dosage
  • Theophylline / therapeutic use


  • Adrenal Cortex Hormones
  • Adrenergic beta-Agonists
  • Anti-Asthmatic Agents
  • Bronchodilator Agents
  • Delayed-Action Preparations
  • Leukotriene Antagonists
  • Theophylline