title: The β-2 agonist debate:  is there still a problem?
abstract: OBJECTIVE
  To present an evidence-based review of the US Food and Drug Administration (FDA) recommendations for long-acting β agonist (LABA) use in asthma.
  
  
  RESULTS
  The FDA recommendation contraindicating the use of LABAs without a concomitant asthma-controller medication such as an inhaled corticosteroid (ICS) is supported, with the caveat that concomitant use of an asthma-controller medication applies only to ICS therapy and not other asthma controller medications (such as leukotriene receptor antagonist therapy or theophylline). The recommendation that LABA therapy be stopped once asthma control is achieved is restrictive. Although downtitration of therapy should be considered in patients with asthma, who are well controlled, other options such as reducing the dose of ICS may be preferable to stopping LABA therapy. In patients who are at risk of unstable asthma or severe exacerbations, maintaining the ICS/LABA therapy without downtitration may be required. The recommendation against LABA use in patients whose asthma is adequately controlled with a low or medium dose ICS is supported. The recommendation that fixed-dose combination ICS/LABA products should be the only form in which LABAs are prescribed in adolescents and paediatric patients should be extended to all asthma patients.
  
  
  CONCLUSIONS
  The current β agonist debate focuses on the optimal management approaches for the use of LABA therapy to both minimize risk and maximize clinical efficacy.
authors.affiliation: Medical Research Institute of New Zealand, New Zealand.
authors.forename: Mitesh
authors.initials: M
authors.lastname: Patel
authors.forename: Philippa
authors.initials: P
authors.lastname: Shirtcliffe
authors.forename: Richard
authors.initials: R
authors.lastname: Beasley
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D001249:Asthma / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D006801:Humans
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists