Asthma symptoms worsen as beta-agonist therapy stepped down

Step-down of long-acting beta-agonist (LABA) therapy risks making patients' asthma symptoms worse, US researchers have warned.

Asthma: UK has clear guidance on use of LABAs with inhaled steroids
Asthma: UK has clear guidance on use of LABAs with inhaled steroids

Dr Jan Brozek and colleagues from McMaster University in Ontario, Canada, examined studies of discontinuation of LABA therapy. They analysed  results of five studies involving 1,292 patients.

Concerns have been raised about the long-term safety of LABA therapy, but research has also suggested that withdrawal of LABA therapy may worsen patients’ symptoms.

Dr Brozek and colleagues found that discontinuation of LABA therapy increased asthma impairment, and reduced patients’ quality of life.

The researchers said doctors ‘need to evaluate the risk-benefit ratio of LABAs for their individual patients’. ‘Results of this review and many previous studies support the positive effects of LABAs for achieving and maintaining asthma control,’ they said.

Erica Evans, asthma nurse specialist at Asthma UK, said the UK was in a ‘privileged position’ internationally in having clear guidelines for LABA use in conjunction with inhaled steroids. She said the UK guidelines recognised the benefits of LABA use for people with asthma.

‘We do however acknowledge that for certain groups they may pose a risk and provide ongoing scrutiny via the MHRA,’ she said.

‘We understand the importance of further evidence to clarify who would benefit most and who would be most at risk with these medicines.'

She added: ‘Asthma UK and the Royal College of Physicians are also conducting the National Review of Asthma Deaths which hopes to reduce asthma deaths by every means possible.’

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