Safety and effectiveness of long-acting inhaled beta-agonist bronchodilators when taken with inhaled corticosteroids

Ann Intern Med. 2006 Nov 7;145(9):692-4. doi: 10.7326/0003-4819-145-9-200611070-00012.


Long-acting beta-agonists are a pillar of therapy for many patients with asthma because they are the preferred add-on therapy to inhaled corticosteroids. However, a recent meta-analysis documented a substantial increase in severe exacerbations requiring hospital admission and life-threatening asthma exacerbations in patients treated with long-acting beta-agonists. A careful evaluation of this meta-analysis raises several concerns about its applicability to current practice. Pivotal trials evaluating the benefit of adding long-acting beta-agonists to inhaled corticosteroids were not included. The authors of the current paper call for physicians to continue their usual practice of using long-acting beta-agonists as adjunctive therapy, as well as for an independent meta-analysis of individual patients using inhaled corticosteroids and long-acting beta-agonists concomitantly.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / adverse effects
  • Adrenergic beta-Agonists / administration & dosage*
  • Adrenergic beta-Agonists / adverse effects
  • Asthma / complications
  • Asthma / drug therapy*
  • Bronchodilator Agents / administration & dosage*
  • Bronchodilator Agents / adverse effects
  • Drug Therapy, Combination
  • Hospitalization
  • Humans
  • Meta-Analysis as Topic
  • Treatment Outcome


  • Adrenal Cortex Hormones
  • Adrenergic beta-Agonists
  • Bronchodilator Agents