title: Fixed-Dose combination of the inhaled corticosteroid and long-acting beta2-agonist therapy in adults with persistent asthma.
abstract: BACKGROUND
  Asthma is a respiratory condition characterized by airway inflammation, airflow obstruction, and bronchial hyperresponsiveness. The standard treatment of asthma comprises inhaled corticosteroid and beta2-agonist. Inhaled short-acting-beta2-agonists have been used as rescue medication for exacerbation. However, long-acting-beta2-agonists (LABA) used as monotherapy for asthma had been reported for having a safety concern. Consequently, it had been recommended as an add-on treatment to inhaled corticosteroid (ICS) in moderate to severe persistent asthma. The fixed-dose combination (FDC) of ICS and LABA has been approved since the year 2000. Evidences revealed using the combination of these medications is more effective in asthma control.
  
  
  METHODS
  The rational and phase III onward randomized-controlled studies were reviewed. Sources of evidences were from studies published in Medline until November 2015.
  
  
  CONCLUSIONS
  There are six FDC inhaler regimens approved worldwide. The significant synergistic effects of ICS and LABA in one device are well evidenced. A FDC reduces the daily dosage of ICS and asthma exacerbation. It is safe to use regularly as controller. The efficacy of each individual combination on asthma treatment is generally similar. Clinical experience, ease of use, cost and side effects of medication would guide the clinician's preferences.
authors.affiliation: a Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine , Chulalongkorn University , Bangkok , Thailand.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Chantaphakul
authors.affiliation: a Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine , Chulalongkorn University , Bangkok , Thailand.
authors.forename: Kiat
authors.initials: K
authors.lastname: Ruxrungtham
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D017326:Clinical Trials, Phase III as Topic; D004338:Drug Combinations; D006801:Humans; D009330:Nebulizers and Vaporizers; D016032:Randomized Controlled Trials as Topic
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D004338:Drug Combinations
keywords: Asthma; fixed-dose combination; inhaled corticosteroid; long-acting Beta2-agonist