PMID- 24429159
OWN - NLM
STAT- MEDLINE
DCOM- 20140220
LR  - 20220318
IS  - 2213-2600 (Print)
IS  - 2213-2600 (Linking)
VI  - 1
IP  - 4
DP  - 2013 Jun
TI  - Are inhaled longacting beta2 agonists detrimental to asthma?
PG  - 339-46
LID - S2213-2600(13)70044-4 [pii]
LID - 10.1016/S2213-2600(13)70044-4 [doi]
AB  - Possible adverse effects of adrenergic bronchodilators in asthma have been the 
      subject of discussion for more than half a century, with recent intense debate 
      about the safety of longacting beta agonists (LABAs). In this Debate, we consider 
      the issues of bronchodilator and bronchoprotective tolerance resulting from the 
      frequent use of bronchodilators, which is noted particularly with shortacting 
      drugs, but has also been shown to occur quicker and to a greater extent with 
      LABAs. Increased allergen responsiveness and masking allowing inflammation to 
      increase, while symptoms and lung function remain apparently controlled, have 
      also been observed. Studies in which LABAs were used as monotherapy were 
      associated with increased mortality. However, several studies have shown the 
      benefits of adding LABAs to inhaled corticosteroids (ICS). Meta-analyses of 
      asthma clinical trials involving LABAs showed that, when given with mandatory 
      ICS, LABAs were not associated with an increased risk of death, intubations, or 
      hospital admission for exacerbations when compared with use of the same dose of 
      ICS only. Withdrawal of LABA therapy once symptom control is achieved is often 
      associated with subsequent loss of symptom control. When used for appropriate 
      indications, LABAs should be combined with ICS in one inhaler so that monotherapy 
      is not possible.
CI  - Copyright (c) 2013 Elsevier Ltd. All rights reserved.
FAU - Cockcroft, Donald W
AU  - Cockcroft DW
AD  - University of Saskatchewan, Royal University Hospital, Department of Medicine, 
      Division of Respirology, Critical Care and Sleep Medicine, Saskatoon, SK, Canada. 
      Electronic address: don.cockcroft@usask.ca.
FAU - Sears, Malcolm R
AU  - Sears MR
AD  - McMaster University/St Joseph's Hospital, Firestone Institute for Respiratory 
      Health, Hamilton, ON, Canada.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20130509
PL  - England
TA  - Lancet Respir Med
JT  - The Lancet. Respiratory medicine
JID - 101605555
RN  - 0 (Adrenergic beta-2 Receptor Agonists)
RN  - 0 (Delayed-Action Preparations)
SB  - IM
MH  - Administration, Inhalation
MH  - Adrenergic beta-2 Receptor Agonists/*administration & dosage
MH  - Asthma/*drug therapy
MH  - Delayed-Action Preparations/administration & dosage
MH  - Humans
MH  - Treatment Outcome
EDAT- 2014/01/17 06:00
MHDA- 2014/02/22 06:00
CRDT- 2014/01/17 06:00
PHST- 2014/01/17 06:00 [entrez]
PHST- 2014/01/17 06:00 [pubmed]
PHST- 2014/02/22 06:00 [medline]
AID - S2213-2600(13)70044-4 [pii]
AID - 10.1016/S2213-2600(13)70044-4 [doi]
PST - ppublish
SO  - Lancet Respir Med. 2013 Jun;1(4):339-46. doi: 10.1016/S2213-2600(13)70044-4. Epub 
      2013 May 9.